Healthcare Provider Details

I. General information

NPI: 1710978291
Provider Name (Legal Business Name): SANDHILL COVE PROPERTIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 09/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SW CAPRI ST
PALM CITY FL
34990-4518
US

IV. Provider business mailing address

1500 SW CAPRI ST
PALM CITY FL
34990-4518
US

V. Phone/Fax

Practice location:
  • Phone: 772-283-7775
  • Fax: 772-283-7092
Mailing address:
  • Phone: 772-283-7775
  • Fax: 772-283-7092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF1585096
License Number StateFL

VIII. Authorized Official

Name: MRS. LISA D. GRIEVE
Title or Position: VICE PRESIDENT, SECRETARY AND TREAS
Credential:
Phone: 515-875-4754