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NPI Code Detail

MEDICARE: CHAUTAUQUA SPRINGS HEALTH CENTER LLC

MEDICARE: CHAUTAUQUA SPRINGS HEALTH CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235865726
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHAUTAUQUA SPRINGS HEALTH CENTER LLC
Provider Business Mailing Address
First Line : 785 S 2ND ST
Second Line :
City : DEFUNIAK SPRINGS
State : FL
Zip : 32435-4903
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 785 S 2ND ST
Second Line :
City : DEFUNIAK SPRINGS
State : FL
Zip : 32435-4903
Country : US
Telephone Number : 850-892-2176
Fax Number :
Authorized Official
Title or Position : CFO
Name : MAYER FISCHL
Credential :
Telephone Number : 718-757-6399
Provider Enumeration Date : 07/27/2022
Last Update Date : 07/27/2022

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Directions to “CHAUTAUQUA SPRINGS HEALTH CENTER LLC ” Practice Location

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