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Contact Information

LAKE WORTH SNF LLC
1711 6TH AVE S
LAKE WORTH, FL33460-4333
 Phone: 561-586-0808
 Fax: 561-585-8757
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Nursing Facility Supplies

332BN1400X 87 All Other Suppliers
 

Parenteral & Enteral Nutrition

332BP3500X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for LAKE WORTH SNF LLC

NPI Number 1861691693
LBN Legal business name LAKE WORTH SNF LLC
Authorized official TZVI BOGOMILSKY - (AUTHORIZED OFFICIAL)
Entity Organization
Organization subpart 1 No
Enumeration date 07/12/2007
Last updated 07/10/2013 - About 13 years ago
Identifiers
FL Medicaid 032503100
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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