LAKESIDE TLF, LLC
NPI 1134722820
Rehabilitation Hospital in Wauchula, FL
NPI Status: Active since November 17, 2020
Contact Information
1962 VANDOLAH RD
WAUCHULA, FL
ZIP 33873
Phone: (800) 697-5390
- Organization
- Rehabilitation Hospital
- Accepts Insurance
- CLIA Number: 10D2213676
- CLIA Cert. Type: Other - TRANSITIONAL LIVING FACIL
- CLIA Exp. Date: 02-15-2027
About LAKESIDE TLF, LLC
This page provides the complete NPI Profile along with additional information for Lakeside Tlf, Llc, a provider established in Wauchula, Florida operating as a Rehabilitation Hospital. The healthcare provider is registered in the NPI registry with number 1134722820 assigned on November 2020. The practitioner's primary taxonomy code is 283X00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Dr. Maneesh Bansal Md (Coo)
- NPI
- 1134722820
- Provider Name
- LAKESIDE TLF, LLC
- Entity Type
- Organization
- Location Address
- 1962 VANDOLAH RD WAUCHULA, FL 33873
- Location Phone
- (800) 697-5390
- Mailing Address
- 10866 WASHINGTON BLVD STE 42 CULVER CITY, CA 90232
- Mailing Phone
- (213) 986-8416
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-17-2020
- Last Update Date
- 11-17-2020
- Code Navigator
Location Map
Secondary Locations
- 1044 S Florida Ave
Wauchula, FL 33873
(863) 773-2857
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Rehabilitation Hospital
- Taxonomy Code
- 283X00000X
- Type
- Hospitals
- Taxonomy Description
- A hospital or facility that provides health-related, social and/or vocational services to disabled persons to help them attain their maximum functional capacity.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 320600000X | Residential Treatment Facilities | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 2 | 320700000X | Residential Treatment Facilities | Residential Treatment Facility, Physical Disabilities | |
| 3 | 322D00000X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D2213676
- Facility Type
- Other - TRANSITIONAL LIVING FACIL
- Certificate Effective Date
- February 16, 2025
- Certificate Expiration Date
- February 15, 2027
- Laboratory Director
- ONOLE M. WELLS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Lakeside Tlf, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for LAKESIDE TLF, LLC
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 3 | 4 | 7 | 2 | 2 | 8 | 2 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 6 | 4 | 14 | 2 | 4 | 8 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 6 + 4 + 1 + 4 + 2 + 4 + 8 + 4 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1134722820 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 11 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1467406793 | SARAH HARVEY O.T. Individual | Occupational Therapist | 1962 VANDOLAH RD WAUCHULA, FL 33873 (863) 767-4411 |
| 1467674341 | MELISSA K JOHNSTON OTRL Individual | Occupational Therapist | 1962 VANDOLAH RD WAUCHULA, FL 33873 (800) 697-5390 |
| 1760694582 | LAUREN RADEN OTRL Individual | Occupational Therapist (Neurorehabilitation) | 1962 VANDOLAH RD WAUCHULA, FL 33873 (863) 767-4411 |
| 1861601510 | SHANNON GORMEL BEATTIE CCC-SLP Individual | Speech-Language Pathologist | 1962 VANDOLAH RD WAUCHULA, FL 33873 (863) 767-4424 |
| 1639389695 | SUSAN RALSTON CCC-SLP Individual | Speech-Language Pathologist | 1962 VANDOLAH RD WAUCHULA, FL 33873 (863) 767-4425 |
| 1881804045 | MISS CARRIE LYNN FRIEDMAN PT Individual | Physical Therapist | 1962 VANDOLAH RD WAUCHULA, FL 33873 (863) 767-4409 |
| 1467662940 | REBECCA BLOCK CCC-SLP Individual | Speech-Language Pathologist | 1962 VANDOLAH RD WAUCHULA, FL 33873 (863) 767-4424 |
| 1326258559 | MISS HUNTER MARIE WILLIAMS PT Individual | Physical Therapist | 1962 VANDOLAH RD WAUCHULA, FL 33873 (863) 767-4409 |
| 1861699977 | KEVIN E O'KEEFE PSYD Individual | Psychologist (Rehabilitation) | 1962 VANDOLAH RD WAUCHULA, FL 33873 (800) 697-5390 |
| 1972859437 | MS. RUTH ANN RAUCH COTA/L Individual | Occupational Therapy Assistant | 1962 VANDOLAH RD WAUCHULA, FL 33873 (863) 767-4411 |
| 1861093981 | LAKESIDE SNF LLC Organization | Skilled Nursing Facility | 1962 VANDOLAH RD WAUCHULA, FL 33873 (800) 697-5390 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1134722820, enumerated in the NPI registry as an "organization" on November 17, 2020
The provider is located at 1962 Vandolah Rd Wauchula, Fl 33873 and the phone number is (800) 697-5390
This medical organization specializes in Rehabilitation Hospital with taxonomy code 283X00000X
The provider might be accepting Accepts: Aetna CVS Health. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 10D2213676 for a "other - transitional living facil" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on November 17, 2020. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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