Organization · NPI-2
Crestview Rehabilitation Center, LLC
Skilled Nursing Facility · Crestview, FL
NPI number1821374505
StatusActive
Last updated in NPPESSep 29, 2014
Details
- NPI
- 1821374505
- Entity type
- Organization (NPI-2)
- Legal business name
- Crestview Rehabilitation Center, LLC
- Organization subpart
- No
- Enumeration date
- Oct 26, 2011
- Last updated
- Sep 29, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | SNF1110096 | FL | Yes |
| 314000000X | Skilled Nursing Facility | – | FL |
Practice location
1849 E First AveCrestview, FL 32539-3109
Phone 850-682-5322 · Fax 850-682-5489
Mailing address
5887 Glenridge Dr NeSuite 150
Atlanta, GA 30328-5574
Phone 404-574-2100 · Fax 404-574-2105
Authorized official
R. Mark Cronquist
Manager
4045742100
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