Sf Brevard, LLC
Skilled Nursing Facility in Lake City, FL. Organization (NPI-2).
NPI number1083170534
StatusActive
Last updated in NPPESFeb 20, 2019
Details
- NPI
- 1083170534
- Entity type
- Organization (NPI-2)
- Legal business name
- Sf Brevard, LLC
- Organization subpart
- Yes
- Enumeration date
- Feb 20, 2019
- Last updated
- Feb 20, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | – | – | Yes |
Other names
- The Rehabilitation Center Of Lake City (Doing Business As)
Practice location
298 Sw Prosperity PlaceLake City, FL 32024
Phone 833-623-3093 · Fax 833-623-3093
Mailing address
298 Sw Prosperity PlaceLake City, FL 32024
Phone 833-623-3093 · Fax 833-623-3093
Authorized official
James Richardson
President
8504300000
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