Healthcare Provider Details
I. General information
NPI: 1376587550
Provider Name (Legal Business Name): PRESBYTERIAN RETIREMENT COMMUNITIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2006
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1533 4TH AVE W
BRADENTON FL
34205-5949
US
IV. Provider business mailing address
80 W LUCERNE CIR
ORLANDO FL
32801-3779
US
V. Phone/Fax
- Phone: 941-747-1881
- Fax: 941-749-6776
- Phone: 407-839-5050
- Fax: 407-849-1718
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | SNF1598096 |
| License Number State | FL |
VIII. Authorized Official
Name:
HENRY
THOMAS
KEITH
Title or Position: CEO
Credential:
Phone: 407-839-5050