Healthcare Provider Details

I. General information

NPI: 1144058207
Provider Name (Legal Business Name): GAINESVILLE HEALTH AND REHAB OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 SW 20TH AVE
GAINESVILLE FL
32607-4417
US

IV. Provider business mailing address

4000 SW 20TH AVE
GAINESVILLE FL
32607-4417
US

V. Phone/Fax

Practice location:
  • Phone: 352-377-1981
  • Fax:
Mailing address:
  • Phone: 352-377-1981
  • 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: AARON DALLAS
Title or Position: CEO/NHA
Credential: NHA
Phone: 352-377-1981