Provider Demographics
NPI:1346649308
Name:NAVAL CONTINUING CARE RETIREMENT FOUNDATION, INC.
Entity Type:Organization
Organization Name:NAVAL CONTINUING CARE RETIREMENT FOUNDATION, INC.
Other - Org Name:FLEET LANDING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. DIRECTOR OF HEALTH CARE SERVICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOLAR
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:904-246-9900
Mailing Address - Street 1:1 FLEET LANDING BLVD
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32233-4599
Mailing Address - Country:US
Mailing Address - Phone:904-246-9900
Mailing Address - Fax:904-246-9566
Practice Address - Street 1:1 FLEET LANDING BLVD
Practice Address - Street 2:
Practice Address - City:ATLANTIC BEACH
Practice Address - State:FL
Practice Address - Zip Code:32233-4599
Practice Address - Country:US
Practice Address - Phone:904-246-9900
Practice Address - Fax:904-246-9566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992171251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health