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Contact Information

LIFE CARE PONTE VEDRA INC
1003 YORK RD
PONTE VEDRA BEACH, FL32082
 Phone: 904-285-1055
 Fax: 904-285-1384
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for LIFE CARE PONTE VEDRA INC

NPI Number 1578573499
LBN Legal business name LIFE CARE PONTE VEDRA INC
Authorized official RAYMOND JOHNSON - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 08/09/2006
Last updated 04/13/2009 - About 17 years ago
Identifiers
FL License # 1574095
FL Other 105630 OSCAR
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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