Shady Lane Retirement Home
NPI 1114253754ActiveOrganization· Assisted Living Facility· Leesburg, FL
Assisted Living Facility in Leesburg, Florida, registered in NPPES in November 2009. The authorized official on file is Segundo Lizardo, Owner/Administrator.
Overview
| NPI | 1114253754 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 1, 2009 |
| Last updated in NPPES | Nov 1, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Assisted Living Facility Primary | 310400000X | AL6001 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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