Still Waters of Lake City, Inc.

NPI #1104160027 in Lake City, Florida

Provider Information

NPI Number: 1104160027
Entity Type: Organization
Organization Name: Still Waters of Lake City, Inc.
Primary Specialty: Assisted Living Facility
Enumeration Date: Nov 15, 2012
Last Updated: Nov 15, 2012

Practice Location

Address: 507 NW HALL OF FAME DR
City: Lake City
State: Florida
ZIP Code: 32055-4835
Phone: (386) 755-6560

Authorized Official

Name: THREASA HYSELL, R.N.
Title: EXECUTIVE DIRECTOR
Phone: (386) 755-6560

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Alzheimer Center (Dementia Center)	311500000X
Custodial Care Facility - Adult Care Home — Adult Care Home	311ZA0620X
Respite Care	385H00000X
Assisted Living Facility	310400000X	Primary

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