NPI 1134722820

Lakeside Tlf, LLC

Organisation Rehabilitation Hospital Wauchula, FL

Practice location

Address: 1962 Vandolah Rd, Wauchula, FL 33873-8726
Phone: (800) 697-5390
Mailing address: 10866 Washington Blvd STE 42, Culver City, CA 90232-3610

Authorised official

Name: Maneesh Bansal
Title: Coo
Phone: (800) 697-5390

Registered specialties (4)

Rehabilitation Hospital Primary

Hospitals Taxonomy 283X00000X

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Intellectual and/or Developmental Disabilities Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320600000X

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Physical Disabilities Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320700000X

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Emotionally Disturbed Childrens' Residential Treatment Facility

Residential Treatment Facilities Taxonomy 322D00000X

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Registry record

NPI: 1134722820
Entity type: Organization
NPI issued: 17 Nov 2020
Record last updated: 17 Nov 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.