Provider Demographics
NPI:1003833831
Name:THE HEALTH CENTER OF PALATKA, INC.
Entity Type:Organization
Organization Name:THE HEALTH CENTER OF PALATKA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-217-2324
Mailing Address - Street 1:110 KAY LARKIN DR
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-2300
Mailing Address - Country:US
Mailing Address - Phone:904-325-0173
Mailing Address - Fax:
Practice Address - Street 1:110 KAY LARKIN DR
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-2300
Practice Address - Country:US
Practice Address - Phone:904-325-0173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF1402096314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2TOtherBCBS
10-5652Medicare ID - Type Unspecified