Organization
LAKEWOOD NURSING CENTER INC
Active
Other names
Putnam Council on Aging, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT W HAGAN (PRESIDENT)
(770) 993-4000
Entity
Organization
Contact information
Practice address
100 N LAKE ST, CRESCENT CITY, FL 32112-2620
(386) 698-2222
(386) 698-2717
Mailing address
100 N LAKE ST, CRESCENT CITY, FL 32112-2620
(386) 698-2222
(386) 698-2717
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031214200
—
FL
Enumeration date
08/10/2005
Last updated
07/18/2019
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