Healthcare Provider Details

I. General information

NPI: 1760451900
Provider Name (Legal Business Name): WOODLANDS CARE CENTER OF CITRUS COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 07/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 W NORVELL BRYANT HWY
HERNANDO FL
34442-5105
US

IV. Provider business mailing address

124 W NORVELL BRYANT HWY
HERNANDO FL
34442-5105
US

V. Phone/Fax

Practice location:
  • Phone: 352-249-3100
  • Fax: 352-746-0748
Mailing address:
  • Phone: 352-249-3100
  • Fax: 352-746-0748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number130471018
License Number StateFL

VIII. Authorized Official

Name: MS. DONNA MARSH
Title or Position: CFO
Credential:
Phone: 386-255-1054