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General NPI Number Information
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NPI Number | 1225053473
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Entity Type | Organization
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Legal Business Name | PRESBYTERIAN RETIREMENT COMMUNITIES, INC.
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 12/29/2008
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Provider Practice Location Address
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Address Line | 1700 21ST AVE W
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City | BRADENTON
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State | FL
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Zip | 34205-5717
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Country | US
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Telephone | 941-748-4161
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Fax | 941-748-6673
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Provider Business Mailing Address
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Address Line | 80 W LUCERNE CIR
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City | ORLANDO
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State | FL
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Zip | 32801-3779
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Country | US
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Telephone | 407-839-5050
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Fax | 407-849-1718
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. HENRY T KEITH
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Credential |
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Telephone | 407-839-5050
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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 | SNF1597096
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License Number State | FL
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