Forest Lake Manor

LBN: Selah - Forest Lake Manor, Llc
Forest Lake Manor is an health care organization with primary practice located at 252 Forest Lake Blvd , Daytona Beach FL 32119-8106. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Selah - Forest Lake Manor, Llc can be contacted via phone (386) 760-7174, or through Parrish, Alan Daniel via phone (904) 543-1818.

Contact Information

Primary practice address
252 Forest Lake Blvd Daytona Beach FL 32119-8106
Phone: (386) 760-7174
Fax: (386) 760-7812
Website:
Map and Directions
Authorized official contact:
Name: Parrish, Alan Daniel
Phone: (904) 543-1818

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X AL8869 Florida

Profile Details

NPI number 1316281215
LBN Legal business name Selah - Forest Lake Manor, Llc
DBA Doing business as Forest Lake Manor
Authorized official Parrish, Alan Daniel
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 15th, 2012
Last updated Nov 15th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316281215 NPPES
Florida MEDICAID 003453400

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