SHADY LANE RETIREMENT HOME
Nursing at Rosefield Ave, Leesburg, FL

License number
Florida AL6001
Category
Nursing
Type
Assisted Living Facility
Owner
Name: MR. SEGUNDO LIZARDO
Title: OWNER/ADMINISTRATOR
Phone: (352) 728-1559
Address
Address
201 Rosefield Ave, Leesburg, FL 34748
National Provider ID: 1114253754
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about SHADY LANE RETIREMENT HOME at bizstanding.com

SHADY LANE RETIREMENT HOME, LLC

Leesburg, FL  -  Windermere, FL

Status:
Inactive
Industry:
Nursing/Personal Care
Doing business as:
Shady Lane Retirement Home
Inactive reason:
Reinstatement
Registration:
Jan 13, 2009
Inactive since:
Oct 9, 2010
Phone:
(352) 728-1559 (Phone)
Addresses:
201 Rosefield Ave, Leesburg, FL 34748 (Physical)
13814 Amelia Pond Dr, Windermere, FL 34786
State ID:
L09000003827
Business type:
Florida Limited Liability Company
Food Service Directors:
Tejesh K Patel (Administration, Managing Member), 13814 Aemlia Pond Dr, Windermere, FL 34786 (Physical),Segundo Lizardo (Administration, Owner),Cecilia Lizardo (Director Of Social),...
Agent:
Tejesh Patel,13814 Amelia Pond Dr, Windermere, FL 34786 (Physical)
EIN:
30-0589766
Categories:
Retirement Communities & Homes
Products:
Geriatric Services, Social Services

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