Healthcare Provider Details

I. General information

NPI: 1003485228
Provider Name (Legal Business Name): ALACHUA COUNTY HRC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 11/03/2023
Certification Date: 11/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6517 NW 39TH AVE
GAINESVILLE FL
32606-5735
US

IV. Provider business mailing address

5270 N US HIGHWAY 1 STE 101
PALM SHORES FL
32940-7216
US

V. Phone/Fax

Practice location:
  • Phone: 321-725-6131
  • Fax:
Mailing address:
  • Phone: 321-725-6131
  • 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: MS. DEBORAH KENNEDY
Title or Position: AUTHORIZED AGENT
Credential:
Phone: 321-725-6131