Healthcare Provider Details

I. General information

NPI: 1619985157
Provider Name (Legal Business Name): SWAN POINTE FACILITY OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 03/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 BUTZ RD
MAUMEE OH
43537-9691
US

IV. Provider business mailing address

800 CONCOURSE PKWY S SUITE 200
MAITLAND FL
32751-6148
US

V. Phone/Fax

Practice location:
  • Phone: 419-867-7926
  • Fax: 419-868-3515
Mailing address:
  • Phone: 407-571-1550
  • Fax: 407-571-1599

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: JOSEPH CONTE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 407-571-1550