Provider Demographics
NPI:1821724329
Name:MARIANNA NURSING AND CARE CENTER LLC
Entity Type:Organization
Organization Name:MARIANNA NURSING AND CARE CENTER LLC
Other - Org Name:COURTYARD HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MAYER
Authorized Official - Middle Name:
Authorized Official - Last Name:FISCHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-757-6399
Mailing Address - Street 1:2600 FOREST GLEN TRL
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32446-0100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2600 FOREST GLEN TRL
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-0100
Practice Address - Country:US
Practice Address - Phone:850-526-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility