Healthcare Provider Details

I. General information

NPI: 1609351899
Provider Name (Legal Business Name): VOA LEE COUNTY HEALTH CARE FACILITY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2018
Last Update Date: 02/05/2021
Certification Date: 02/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14750 HOPE CENTER LOOP
FT. MYERS FL
33912
US

IV. Provider business mailing address

7485 OFFICE RIDGE CIR
EDEN PRAIRIE MN
55344-3690
US

V. Phone/Fax

Practice location:
  • Phone: 952-941-0305
  • Fax:
Mailing address:
  • Phone: 952-983-4249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: NANCY A GAVIN
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 952-983-4249