Healthcare Provider Details

I. General information

NPI: 1538745864
Provider Name (Legal Business Name): JACKSONVILLE FL OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2021
Last Update Date: 03/18/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8495 NORMANDY BLVD
JACKSONVILLE FL
32221-6701
US

IV. Provider business mailing address

8495 NORMANDY BLVD
JACKSONVILLE FL
32221-6701
US

V. Phone/Fax

Practice location:
  • Phone: 904-783-3749
  • Fax:
Mailing address:
  • Phone: 904-783-3749
  • 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: SHLOMO E HELLER
Title or Position: CEO, EMPIRE CARE CENTERS
Credential:
Phone: 470-737-0111