LAKESIDE SNF LLC
NPI 1861093981
Skilled Nursing Facility in Wauchula, FL

Active since November 04, 2020CLIA 10D2213676 · Waiver
1962 VANDOLAH RD, WAUCHULA, FL 33873(800) 697-5390 Get Directions Write a Review

NPPES record last updated: April 14, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 14, 2021, Nov 4, 2020 (2 updates tracked since 2020).

About Lakeside Snf Llc NPPES

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

LAKESIDE SNF LLC (NPI 1861093981) is a healthcare organization registered as a skilled nursing facility in Wauchula, Florida and active in the NPI registry since November 2020. The organization holds a CLIA Waiver certificate valid through February 15, 2027 and lists Maneesh Bansal, Ceo, as its authorized official.

NPPES Registry Identity

NPI1861093981
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameLAKESIDE SNF LLC
Location Address1962 VANDOLAH RDWauchula, FL 33873-8726
Mailing Address1962 Vandolah RdWauchula, FL 33873-8726 · (863) 773-2857
Organization SubpartNo
Authorized OfficialManeesh BansalCeo · (800) 697-5390
Enumeration DateNovember 4, 2020
Last NPPES UpdateApril 14, 20212 updates tracked since enumeration
NPPES CertifiedApril 14, 2021
NPI 1861093981 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
1962 VANDOLAH RD, Wauchula, FL 33873

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2213676

Lakeside Neurologic · Wauchula, FL
Active · expires Feb 15, 2027
CLIA Number10D2213676
Laboratory TypeTransitional Living Facil
Certificate Effective DateFebruary 16, 2025
Certificate Expiration DateFebruary 15, 2027
Laboratory DirectorSteve M. Gowan
Laboratory Phone(863) 245-6717
Laboratory LocationLakeside Neurologic1962 Vandolah Rd, Wauchula, FL 33873
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

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

Rehabilitation Hospital
1962 VANDOLAH RD
WAUCHULA, FL 33873
Physical Therapist
1962 VANDOLAH RD
WAUCHULA, FL 33873
Occupational Therapist
1962 VANDOLAH RD
WAUCHULA, FL 33873
Speech-Language Pathologist
1962 VANDOLAH RD
WAUCHULA, FL 33873
Occupational Therapist
1962 VANDOLAH RD
WAUCHULA, FL 33873
Speech-Language Pathologist
1962 VANDOLAH RD
WAUCHULA, FL 33873
Occupational Therapist (Neurorehabilitation)
1962 VANDOLAH RD
WAUCHULA, FL 33873
Speech-Language Pathologist
1962 VANDOLAH RD
WAUCHULA, FL 33873

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 Lakeside Snf LLC's NPI number?

The NPI number for Lakeside Snf LLC is 1861093981. It was assigned to this organization in the NPPES registry on November 4, 2020.

Where is Lakeside Snf LLC located?

Lakeside Snf LLC is located at 1962 Vandolah Rd, Wauchula, FL 33873. The listed phone number is (800) 697-5390.

What is Lakeside Snf LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Lakeside Snf LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2213676) is associated with this NPI, valid through February 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lakeside Snf LLC accept?

Health plans from Health First Commercial Plans, Inc. list Lakeside Snf LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lakeside Snf LLC was last updated on April 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.