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NPI Code Detail

MEDICARE: CLEAR WATER CARE ACQUISITION LLC

MEDICARE: CLEAR WATER CARE ACQUISITION 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 : 1982195111
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLEAR WATER CARE ACQUISITION LLC
Provider Business Mailing Address
First Line : 1000 GATES AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11221-6295
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2055 PALMETTO ST
Second Line :
City : CLEARWATER
State : FL
Zip : 33765-2118
Country : US
Telephone Number : 727-461-6613
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : LEOPOLD FRIEDMAN
Credential :
Telephone Number : 718-852-7000
Provider Enumeration Date : 05/23/2018
Last Update Date : 06/12/2024

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Directions to “CLEAR WATER CARE ACQUISITION LLC ” Practice Location

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