Organization
MADISON HEALTH INVESTORS, LC
Active
Other names
Lake Park of Madison
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES E. TREFZGER JR. (MANAGING MEMBER)
(828) 322-5535
Entity
Organization
Contact information
Practice address
259 SW CAPTAIN BROWN RD, MADISON, FL 32340-4316
(850) 973-8277
(850) 973-4006
Mailing address
259 SW CAPTAIN BROWN RD, MADISON, FL 32340-4316
(850) 973-8277
(850) 973-4006
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF16360961
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021192300
—
FL
01
—
24003
STATE FACILITY MDS ID NUM
FL
Enumeration date
09/22/2005
Last updated
03/16/2010
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