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General NPI Number Information
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NPI Number | 1225763691
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Entity Type | Organization
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Legal Business Name | ORMOND REHABILITATION AND NURSING CENTER LLC
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Dates
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Enumeration Date | 07/20/2022
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 103 CLYDE MORRIS BLVD
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5982
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Country | US
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Telephone | 386-673-0450
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Fax | 386-676-1302
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Provider Business Mailing Address
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Address Line | 103 CLYDE MORRIS BLVD
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5982
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Country | US
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Telephone | 386-673-0450
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Fax | 386-676-1302
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Authorized Official
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Title or Position | MEMBER
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Name | MOSHE KELMAN
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Credential |
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Telephone | 917-613-1662
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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 |
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License Number State |
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