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General NPI Number Information
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NPI Number | 1053480061
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Entity Type | Organization
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Legal Business Name | CENTRE POINTE HRC LLC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 2255 CENTERVILLE RD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4315
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Country | US
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Telephone | 850-386-4054
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Fax | 850-422-3206
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Provider Business Mailing Address
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Address Line | 2255 CENTERVILLE RD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4315
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Country | US
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Telephone | 850-386-4054
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Fax | 321-725-6168
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Authorized Official
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Title or Position | PRESIDENT AND COO
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Name | JEFF CLEVELAND
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Credential |
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Telephone | 321-725-6131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 1081-96A
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License Number State | FL
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