Ets Willowbrook at Marion

NPI #1114420502 in Lake City, Florida

Provider Information

NPI Number: 1114420502
Entity Type: Organization
Organization Name: Ets Willowbrook at Marion
Primary Specialty: Assisted Living Facility
Enumeration Date: Mar 13, 2018
Last Updated: Mar 13, 2018

Practice Location

Address: 1580 S MARION AVE
City: Lake City
State: Florida
ZIP Code: 32025-6913
Phone: (386) 752-4454

Authorized Official

Name: MR. JON SKYLAR BURGESS
Title: SECRETARY/TREASURER
Phone: (614) 565-5636

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assisted Living Facility	310400000X	Primary

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