OrganizationActive
1031cf Lake City Mt LLC
NPI 1336903400 · Assisted Living Facility · Lake City, FL
Provider details
- NPI number
- 1336903400
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Authorized official
- Edward Fernandez, Manager
Practice location
213 Nw Gleason Dr
Lake City, FL 32055-5846
Phone: (386) 344-6985
Fax: (386) 438-5272
Mailing address
213 Nw Gleason Dr
Lake City, FL 32055-5846
Registry dates
- Enumerated
- 2024-02-09
- Last updated
- 2024-02-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.