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WILLOWBROOK
NPI 1114420502
Assisted Living Facility in Lake City, FL

Active since March 13, 2018
1580 S MARION AVE, LAKE CITY, FL 32025(386) 752-4454 Get Directions Write a Review

NPPES record last updated: March 13, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Willowbrook NPPES

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

WILLOWBROOK (NPI 1114420502) is a healthcare organization registered as an assisted living facility in Lake City, Florida and active in the NPI registry since March 2018. The organization lists Jon Skylar Burgess, Secretary/treasurer, as its authorized official.

NPPES Registry Identity

NPI1114420502
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameETS WILLOWBROOK AT MARION
Location Address1580 S MARION AVELake City, FL 32025-6913
Mailing Address7225 Drucilla StPickerington, OH 43147-7962 · (740) 964-1240
Phone(386) 752-4454
Organization SubpartNo
Authorized OfficialJon Skylar BurgessSecretary/treasurer · (614) 565-5636
Enumeration DateMarch 13, 2018
✔ NPI 1114420502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in FL · 9909
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.

1580 S MARION AVE, Lake City, FL 32025
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Other Names 1

Doing Business AsWillowbrook

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 Ets Willowbrook At Marion's NPI number?

The NPI number for Ets Willowbrook At Marion is 1114420502. It was assigned to this organization in the NPPES registry on March 13, 2018. The provider is doing business as Willowbrook.

Where is Ets Willowbrook At Marion located?

Ets Willowbrook At Marion is located at 1580 S Marion Ave, Lake City, FL 32025. The listed phone number is (386) 752-4454.

What is Ets Willowbrook At Marion'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 Ets Willowbrook At Marion was last updated on March 13, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.