Healthcare Provider Details

I. General information

NPI: 1033942586
Provider Name (Legal Business Name): ARABELLA HEALTH & WELLNESS OF PENSACOLA OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 W AVERY ST
PENSACOLA FL
32501-1811
US

IV. Provider business mailing address

1717 W AVERY ST
PENSACOLA FL
32501-1811
US

V. Phone/Fax

Practice location:
  • Phone: 850-434-2355
  • Fax:
Mailing address:
  • Phone: 850-434-2355
  • 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: CHAIM N HERTZEL
Title or Position: MANAGER
Credential:
Phone: 901-930-6124