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General NPI Number Information
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NPI Number | 1700861051
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Entity Type | Organization
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Legal Business Name | SV - JUPITER PROPERTIES INC
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Dates
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Enumeration Date | 12/09/2005
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Last Update Date | 06/04/2012
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Provider Practice Location Address
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Address Line | 1717 W AVERY ST
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City | PENSACOLA
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State | FL
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Zip | 32501-1811
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Country | US
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Telephone | 850-434-2355
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Fax | 850-433-9547
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Provider Business Mailing Address
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Address Line | 1717 W AVERY ST
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City | PENSACOLA
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State | FL
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Zip | 32501-1811
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Country | US
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Telephone | 850-434-2355
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Fax | 850-433-9547
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Authorized Official
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Title or Position | CONTROLLER
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Name | MRS. RHONDA NELSON
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Credential |
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Telephone | 864-578-6599
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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 | SNF1434096
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License Number State | FL
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