MEDICARE: SANDHILL COVE PROPERTIES 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
1	314000000X	Skilled Nursing Facility	SNF1585096	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710978291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANDHILL COVE PROPERTIES INC.

Provider Business Mailing Address
First Line	:	1500 SW CAPRI ST
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-4518
Country	:	US
Telephone Number	:	772-283-7775
Fax Number	:	772-283-7092

Provider Business Practice Location Address
First Line	:	1500 SW CAPRI ST
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-4518
Country	:	US
Telephone Number	:	772-283-7775
Fax Number	:	772-283-7092

Authorized Official
Title or Position	:	VICE PRESIDENT, SECRETARY AND TREAS
Name	:	MRS. LISA D. GRIEVE
Credential	:
Telephone Number	:	515-875-4754

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	09/23/2011

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