Organization · Type 2 NPI

Shady Lane Retirement Home

Assisted Living Facility · Leesburg, FL

NPI number 1114253754 Active

Practice location

201 Rosefield Ave
Leesburg, FL 34748-5014

Call (352) 728-1559 Map

Fax (352) 728-1703

Specialties and licenses

TaxonomyCodeLicense
Assisted Living Facility Primary 310400000XAL6001 (FL)

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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About NPI 1114253754

Shady Lane Retirement Home's National Provider Identifier is 1114253754, issued on Nov 1, 2009. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Leesburg, FL. The record was last updated on Nov 1, 2009.