Healthcare Provider Details

I. General information

NPI: 1851762876
Provider Name (Legal Business Name): ATLANTIC CARE AND REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2015
Last Update Date: 07/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3663 15TH AVE
VERO BEACH FL
32960-4868
US

IV. Provider business mailing address

3663 15TH AVE
VERO BEACH FL
32960-4868
US

V. Phone/Fax

Practice location:
  • Phone: 772-567-2552
  • Fax:
Mailing address:
  • Phone: 772-567-2552
  • 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: PETER LEWIS
Title or Position: AUTHORIZED REPRESENTATIVE
Credential:
Phone: 850-668-7141