Healthcare Provider Details

I. General information

NPI: 1972572709
Provider Name (Legal Business Name): WOODLANDS CARE CENTER OF ALACHUA COUNTY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 06/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7207 SW 24TH AVE
GAINESVILLE FL
32607
US

IV. Provider business mailing address

7207 SW 24TH AVE
GAINESVILLE FL
32607
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-0600
  • Fax: 352-331-7752
Mailing address:
  • Phone: 352-333-0600
  • Fax: 352-331-2974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number130471021
License Number StateFL

VIII. Authorized Official

Name: CHET MALANOWSKI
Title or Position: ADMINISTRATOR
Credential:
Phone: 352-333-0600