Healthcare Provider Details
I. General information
NPI: 1225787419
Provider Name (Legal Business Name): THE CLUB HEALTHCARE AND REHABILITATION CENTER AT THE VILLAGES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/23/2022
Last Update Date: 03/28/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16529 SE 86TH BELLE MEADE CIR
THE VILLAGES FL
32162-5885
US
IV. Provider business mailing address
16529 SE 86TH BELLE MEADE CIR
THE VILLAGES FL
32162-5885
US
V. Phone/Fax
- Phone: 352-385-8200
- 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:
MOSHE
SCHEINER
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 845-490-6060