Organization · NPI-2

500 Hospital Dr Opco LLC

Skilled Nursing Facility · Crestview, FL

NPI number1346012671
StatusActive
Last updated in NPPESApr 9, 2025

Details

NPI
1346012671
Entity type
Organization (NPI-2)
Legal business name
500 Hospital Dr Opco LLC
Organization subpart
No
Enumeration date
Oct 30, 2023
Certification date
Apr 9, 2025
Last updated
Apr 9, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
314000000X Skilled Nursing Facility––Yes

Other names

  • Aviata At Shoal Creek (Doing Business As)

Practice location

500 Hospital Dr
Crestview, FL 32539-7355

Phone 850-689-3146 · Fax 850-689-2286

Mailing address

500 Hospital Dr
Crestview, FL 32539-7355

Phone 850-689-3146 · Fax 850-689-2286

Authorized official

Nathan Freund
Manager
7327307480

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Skilled Nursing Facility providers in Crestview, FL