Provider Demographics
NPI:1104360098
Name:PSL REHABILITATION AND HEALTHCARE LLC
Entity Type:Organization
Organization Name:PSL REHABILITATION AND HEALTHCARE LLC
Other - Org Name:PORT ST. LUCIE REHABILITATION AND HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ZEV
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEMESH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-512-7848
Mailing Address - Street 1:7300 OLEANDER AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-8221
Mailing Address - Country:US
Mailing Address - Phone:772-466-4100
Mailing Address - Fax:772-466-4135
Practice Address - Street 1:7300 OLEANDER AVE
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952
Practice Address - Country:US
Practice Address - Phone:772-466-4100
Practice Address - Fax:772-466-4135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-12
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1452096314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility