Provider Demographics
NPI:1962687343
Name:SPRINGTREE REHABILITATION & HEALTH CARE CTR, LLC
Entity Type:Organization
Organization Name:SPRINGTREE REHABILITATION & HEALTH CARE CTR, LLC
Other - Org Name:DBA SPRINGTREE REHABILITATION & HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-572-4251
Mailing Address - Street 1:4251 SPRINGTREE DR
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6119
Mailing Address - Country:US
Mailing Address - Phone:954-572-4251
Mailing Address - Fax:954-572-6410
Practice Address - Street 1:4251 SPRINGTREE DR
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6119
Practice Address - Country:US
Practice Address - Phone:954-572-4251
Practice Address - Fax:954-572-6410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF15120961314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105686Medicare PIN