Provider Demographics
NPI:1003485228
Name:ALACHUA COUNTY HRC, LLC
Entity Type:Organization
Organization Name:ALACHUA COUNTY HRC, LLC
Other - Org Name:MAGNOLIA RIDGE HRC, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED AGENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-725-6131
Mailing Address - Street 1:5270 N US HIGHWAY 1 STE 101
Mailing Address - Street 2:
Mailing Address - City:PALM SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7216
Mailing Address - Country:US
Mailing Address - Phone:321-725-6131
Mailing Address - Fax:
Practice Address - Street 1:6517 NW 39TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-5735
Practice Address - Country:US
Practice Address - Phone:321-725-6131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility