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NPI Code Detail

MEDICARE: LANIER REHABILITATION CENTER LLC

MEDICARE: LANIER REHABILITATION CENTER 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
1314000000XSkilled Nursing Facility

Other Identifiers

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

General Provider Information

NPI Number : 1932685880
Entity Type Code : Organization
Provider Name (Legal Business Name) : LANIER REHABILITATION CENTER LLC
Provider Business Mailing Address
First Line : 101 SUNNYTOWN RD STE 201
Second Line :
City : CASSELBERRY
State : FL
Zip : 32707-3862
Country : US
Telephone Number : 470-830-5309
Fax Number : 470-830-7775
Provider Business Practice Location Address
First Line : 12740 LANIER RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32226-1704
Country : US
Telephone Number : 904-757-2548
Fax Number : 904-475-7047
Authorized Official
Title or Position : CFO
Name : MR. DON MELTON
Credential :
Telephone Number : 407-830-5309
Provider Enumeration Date : 07/13/2018
Last Update Date : 07/13/2018

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Practice Location Address:
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1245001437 — CHRYSTAL ELIZABETH NELSON
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Practice Fax: 800-388-0270

Directions to “LANIER REHABILITATION CENTER LLC ” Practice Location

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