Healthcare Provider Details

I. General information

NPI: 1114671104
Provider Name (Legal Business Name): SUWANNEE OPERATING INVESTMENTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2022
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 HELVENSTON ST SE
LIVE OAK FL
32064-3474
US

IV. Provider business mailing address

974 ROUTE 45 STE 1200
POMONA NY
10970-3568
US

V. Phone/Fax

Practice location:
  • Phone: 386-362-7860
  • Fax:
Mailing address:
  • Phone:
  • 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: RHEA GOODWIN
Title or Position: COO
Credential:
Phone: 267-800-8008