Healthcare Provider Details
I. General information
NPI: 1619348257
Provider Name (Legal Business Name): SOLARIS HEALTHCARE IMPERIAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/08/2015
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
900 IMPERIAL GOLF COURSE BLVD
NAPLES FL
34110-1085
US
IV. Provider business mailing address
PO BOX 3310
WINDERMERE FL
34786-3310
US
V. Phone/Fax
- Phone: 239-591-4800
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMIE
R
WEIS-JONES
Title or Position: MANAGER
Credential:
Phone: 239-591-4800