Organization
PORT CHARLOTTE FACILITY OPERATIONS, LLC
Active
Other names
Port Charlotte Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH USSERY (VP)
(407) 571-1550
Entity
Organization
Contact information
Practice address
18480 COCHRAN BLVD, PORT CHARLOTTE, FL 33948-3379
(941) 743-4700
(941) 743-2358
Mailing address
18480 COCHRAN BLVD, PORT CHARLOTTE, FL 33948-3379
(941) 743-4700
(941) 743-2358
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF130470983
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008041600
—
FL
Enumeration date
07/25/2006
Last updated
12/22/2021
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