NPIMap

Organization Active NPI

Lake Wales Health Care Operations Company LLC

Doing business as Astoria Health and Rehabilitation Center

  • Skilled Nursing Facility
  • Winter Haven, FL
National Provider Identifier
1245547868
Registry record updated Oct 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LAKE WALES HEALTH CARE OPERATIONS COMPANY LLC
Doing business as
Astoria Health and Rehabilitation Center
Practice address
701 Overlook Dr
Winter Haven, FL 33884-1671
Phone
(863) 318-5000
NPI assigned
Sep 2, 2010
Last updated
Oct 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Dwight A Ott, HFA
Title
Secretary/Treasurer
Phone
(765) 664-5400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

701 Overlook Dr
Winter Haven, FL 33884-1671

Mailing address

701 Overlook Dr
Winter Haven, FL 33884-1671
Phone (863) 318-5000

Other names 1

  • ASTORIA HEALTH AND REHABILITATION CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101012001399 FL Part A Provider - Skilled Nursing Facility 1951593672 Practice locations: Winter Haven, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245547868. Details of each certification follow.

Skilled nursing facility certification: CCN 106086

Legal name
LAKE WALES HEALTH CARE OPERATIONS COMPANY LLC
Doing business as
ASTORIA HEALTH AND REHABILITATION CENTER/THE VILLAGE AT VIENNA SQUARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Dec 13, 2010
Last certification
Mar 26, 2024
Beds
132
Ownership / control type
Corporation
Multi-facility organization
TLC Management
Organization structure
LLCProprietary
Incorporated
Sep 8, 2005 in IN
Enrollment address
701 Overlook Drive South East
Winter Haven, FL 33884-1671
Nursing home name
ASTORIA HEALTH AND REHABILITATION CENTER
Affiliated entity
TLC MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Astoria Health and Rehabilitation CenterCCN 106086 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Dec 13, 2010
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
132125.9 residents per day on average
Chain
TLC Management20 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1107765Astoria Health and Rehabilitation Center701 Overlook Dr, Winter Haven, FL 33884Certificate of waiverNov 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Astoria Health and Rehabilitation Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1387 Vienna Square Dr
Winter Haven, FL 33884

701 Overlook Dr
#S
Winter Haven, FL 33884
Phone (863) 318-5000

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Aleixo M Viegas Individual Operational/Managerial Control Apr 1, 2014
Adp of the SNF Apr 1, 2014
Cullen S Gibson Individual 5% Or Greater Direct Ownership InterestVice President Dec 1, 2012 8%
Corporate OfficerVice President Dec 1, 2012 8%
Adp of the SNF Dec 1, 2012
Cory Blackwell Individual Operational/Managerial Control Feb 15, 2022
Adp of the SNF Feb 15, 2022
Gary L Ott Individual 5% Or Greater Direct Ownership InterestChairman Dec 1, 2012 50%
Corporate OfficerChairman of the Board Jun 30, 2008 50%
Adp of the SNF Dec 1, 2012
Dwight a Ott Individual 5% Or Greater Direct Ownership Interest Sep 8, 2005 23%
Corporate OfficerSecretary/Treasurer Sep 8, 2005 23%
Adp of the SNF Dec 1, 2012
Steven Lanham Individual 5% Or Greater Direct Ownership Interest Sep 8, 2005 10%
Adp of the SNF Dec 1, 2012
Tender Loving Care Management Inc Organization, Marion, IN Corporation, Management services company, For-profit Operational/Managerial Control Sep 5, 2005
Adp of the SNF Mar 10, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 19

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 19

Practitioners & affiliated clinicians

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285891200000",
    "number": "1245547868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 OVERLOOK DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338841671",
            "telephone_number": "863-318-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 OVERLOOK DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338841671",
            "telephone_number": "863-318-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE WALES HEALTH CARE OPERATIONS COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-02",
        "last_updated": "2010-10-01",
        "status": "A",
        "authorized_official_last_name": "OTT",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "765-664-5400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "HFA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ASTORIA HEALTH AND REHABILITATION CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.