Organization
LUBIS ENTERPRISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVIANO LUBIS (OWNER)
(407) 761-5456
Entity
Organization
Contact information
Practice address
10155 SE 110TH STREET RD, BELLEVIEW, FL 34420-3694
(352) 687-8001
Mailing address
10155 SE 110TH STREET RD, BELLEVIEW, FL 34420-3694
(352) 687-8001
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10505
FL
Other
Enumeration date
09/09/2016
Last updated
05/11/2020
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