LAKE MORTON PLAZA
NPI 1801230206
Assisted Living Facility in Lakeland, FL

Q: What is Nic 5 Lake Morton Plaza Leasing LLC's NPI number?

The NPI number for Nic 5 Lake Morton Plaza Leasing LLC is 1801230206. It was assigned to this organization in the NPPES registry on April 29, 2013. The provider is doing business as Lake Morton Plaza.

Q: What is Nic 5 Lake Morton Plaza Leasing LLC's specialty?

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

Active since April 29, 2013

400 S FLORIDA AVE, LAKELAND, FL 33801(863) 683-1000(863) 682-7854 Get Directions Write a Review

NPPES record last updated: November 30, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Lake Morton Plaza NPPES

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

LAKE MORTON PLAZA (NPI 1801230206) is a healthcare organization registered as an assisted living facility in Lakeland, Florida and active in the NPI registry since April 2013. The organization lists Jane Ryu, President/ceo/cfo, as its authorized official.

NPPES Registry Identity

NPI1801230206

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameNIC 5 LAKE MORTON PLAZA LEASING LLC

Location Address400 S FLORIDA AVELakeland, FL 33801

Mailing AddressPo Box 1700 C/o Holiday Retirement, Nic 5 Lake Morton Plaza Leasing LlcLake Oswego, OR 97035 · (971) 245-8020 · Fax (503) 431-2295

Phone(863) 683-1000

Fax(863) 682-7854

Organization SubpartNo

Authorized OfficialJane RyuPresident/ceo/cfo · (212) 479-5270

Enumeration DateApril 29, 2013

Last NPPES UpdateNovember 30, 2016

✔ NPI 1801230206 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 · 5308

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.

400 S FLORIDA AVE, Lakeland, FL 33801

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Other Names 1

Doing Business AsLake Morton Plaza

Other Providers at the Same Location NPPES 4

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

LAKE MORTON PLAZA, LLC

Assisted Living Facility

400 S FLORIDA AVE
LAKELAND, FL 33801

Polk County (863) 683-1000

TRAVIS BOSCIA DPT

Physical Therapist

400 S FLORIDA AVE
LAKELAND, FL 33801

Polk County (863) 683-1000

SYDNEY CLAIRE JOHNSON

Occupational Therapist

400 S FLORIDA AVE
LAKELAND, FL 33801

Polk County (919) 424-5080

GAHC4 LAKE MORTON FL TRS SUB, LLC

Assisted Living Facility

400 S FLORIDA AVE
LAKELAND, FL 33801

Polk County (863) 774-6510

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 Nic 5 Lake Morton Plaza Leasing LLC's NPI number?

The NPI number for Nic 5 Lake Morton Plaza Leasing LLC is 1801230206. It was assigned to this organization in the NPPES registry on April 29, 2013. The provider is doing business as Lake Morton Plaza.

Where is Nic 5 Lake Morton Plaza Leasing LLC located?

Nic 5 Lake Morton Plaza Leasing LLC is located at 400 S Florida Ave, Lakeland, FL 33801. The listed phone number is (863) 683-1000.

What is Nic 5 Lake Morton Plaza Leasing LLC'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 Nic 5 Lake Morton Plaza Leasing LLC was last updated on November 30, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.