STILL WATERS OF LAKE CITY, INC.
NPI 1104160027
Assisted Living Facility in Lake City, FL

Q: What is Still Waters Of Lake City, Inc.'s NPI number?

The NPI number for Still Waters Of Lake City, Inc. is 1104160027. It was assigned to this organization in the NPPES registry on November 15, 2012.

Q: What is Still Waters Of Lake City, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since November 15, 2012

507 NW HALL OF FAME DR, LAKE CITY, FL 32055(386) 755-6560(386) 628-5018 Get Directions Write a Review

NPPES record last updated: November 15, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Still Waters Of Lake City, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STILL WATERS OF LAKE CITY, INC. (NPI 1104160027) is a healthcare organization registered as an assisted living facility in Lake City, Florida and active in the NPI registry since November 2012. The organization lists Threasa Hysell, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1104160027

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameSTILL WATERS OF LAKE CITY, INC.

Location Address507 NW HALL OF FAME DRLake City, FL 32055-4835

Mailing Address507 Nw Hall Of Fame DrLake City, FL 32055-4835 · (386) 755-6560 · Fax (386) 628-5018

Phone(386) 755-6560

Fax(386) 628-5018

Organization SubpartNo

Authorized OfficialThreasa HysellExecutive Director · (386) 755-6560

Enumeration DateNovember 15, 2012

✔ NPI 1104160027 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in FL · AL9472

Definition

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.

Also ListedAlzheimer Center (Dementia Center)Taxonomy 311500000X · License AL9472 (FL)

Also ListedCustodial Care Facility · Adult Care HomeTaxonomy 311ZA0620X · License AL9472 (FL)

Also ListedRespite CareTaxonomy 385H00000X · License AL9472 (FL)

507 NW HALL OF FAME DR, Lake City, FL 32055

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Other Identifiers 1

Other682130800FL · Medicaid Waiver

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THERAPYCARE HOME HEALTH LLC

Home Health

507 NW HALL OF FAME DR
LAKE CITY, FL 32055

Columbia County (904) 246-3436

WILLOWBROOK WEST LLC

Assisted Living Facility

507 NW HALL OF FAME DR
LAKE CITY, FL 32055

Columbia County (386) 755-6560

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Still Waters Of Lake City, Inc.'s NPI number?

The NPI number for Still Waters Of Lake City, Inc. is 1104160027. It was assigned to this organization in the NPPES registry on November 15, 2012.

Where is Still Waters Of Lake City, Inc. located?

Still Waters Of Lake City, Inc. is located at 507 NW Hall Of Fame Dr, Lake City, FL 32055. The listed phone number is (386) 755-6560.

What is Still Waters Of Lake City, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Still Waters Of Lake City, Inc. was last updated on November 15, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.