Organization
1937 JENKS AVENUE OPERATIONS LLC
Active
Other names
Sea Breeze Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH USSERY (VP)
(407) 571-1550
Entity
Organization
Contact information
Practice address
1937 JENKS AVE, PANAMA CITY, FL 32405-4510
(850) 769-7686
(850) 769-7680
Mailing address
1937 JENKS AVE, PANAMA CITY, FL 32405-4510
(850) 769-7686
(850) 769-7680
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF11870961
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005987400
—
FL
Enumeration date
12/27/2011
Last updated
05/10/2019
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