Healthcare Provider Details

I. General information

NPI: 1326289109
Provider Name (Legal Business Name): COURTYARD GARDENS REHABILITATION CENTER, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2009
Last Update Date: 03/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17781 THELMA AVE
JUPITER FL
33458-7942
US

IV. Provider business mailing address

631 US HIGHWAY 1 SUITE 303
NORTH PALM BEACH FL
33408-4617
US

V. Phone/Fax

Practice location:
  • Phone: 561-746-9866
  • Fax:
Mailing address:
  • Phone: 561-845-7767
  • Fax: 561-828-7641

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: DR. GEORGE CHARLES PECK
Title or Position: CEO
Credential: M.D.
Phone: 561-845-7767