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NPI Code Detail

MEDICARE: CAROLINE CREEK HEALTHCARE, INC.

MEDICARE: CAROLINE CREEK HEALTHCARE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1245166099
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAROLINE CREEK HEALTHCARE, INC.
Provider Business Mailing Address
First Line : 5888 BLANDING BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32244-1927
Country : US
Telephone Number : 904-772-1220
Fax Number : 949-540-3007
Provider Business Practice Location Address
First Line : 5888 BLANDING BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32244-1927
Country : US
Telephone Number : 904-772-1220
Fax Number : 949-540-3007
Authorized Official
Title or Position : SECRETARY
Name : SOON BURNAM
Credential :
Telephone Number : 949-540-1249
Provider Enumeration Date : 06/19/2026
Last Update Date : 06/19/2026

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Directions to “CAROLINE CREEK HEALTHCARE, INC. ” Practice Location

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