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NPI Code Detail

MEDICARE: BLC ATRIUM JACKSONVILLE SNF LLC

MEDICARE: BLC ATRIUM JACKSONVILLE SNF LLC
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
1310400000XAssisted Living FacilityAL7109FL
2314000000XSkilled Nursing FacilitySNF1648096FL

General Provider Information

NPI Number : 1316031263
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLC ATRIUM JACKSONVILLE SNF LLC
Provider Business Mailing Address
First Line : 9960 ATRIUM WAY
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32225-6487
Country : US
Telephone Number : 904-724-4726
Fax Number :
Provider Business Practice Location Address
First Line : 9960 ATRIUM WAY
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32225-6487
Country : US
Telephone Number : 904-724-4726
Fax Number :
Authorized Official
Title or Position : SENIOR VICE PRESIDENT
Name : MS. JOANNE K LESKOWICZ
Credential :
Telephone Number : 414-918-5000
Provider Enumeration Date : 10/03/2006
Last Update Date : 09/20/2018

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Directions to “BLC ATRIUM JACKSONVILLE SNF LLC ” Practice Location

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