Shady Lane Retirement Home
NPI #1114253754 in Leesburg, Florida
Provider Information
- NPI Number
- 1114253754
- Entity Type
- Organization
- Organization Name
- Shady Lane Retirement Home
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Nov 1, 2009
- Last Updated
- Nov 1, 2009
Practice Location
Authorized Official
- Name
- MR. SEGUNDO LIZARDO
- Title
- OWNER/ADMINISTRATOR
- Phone
- (352) 728-1559
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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