Healthcare Provider Details

I. General information

NPI: 1659276913
Provider Name (Legal Business Name): OCOEE JOHNSON CITY CCRC HEALTH & REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2012 SHERWOOD DR
JOHNSON CITY TN
37601-3238
US

IV. Provider business mailing address

2012 SHERWOOD DR
JOHNSON CITY TN
37601-3238
US

V. Phone/Fax

Practice location:
  • Phone: 423-232-8200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOHN SHEEHAN
Title or Position: PRESIDENT
Credential:
Phone: 423-618-1488