Organization
CCRC OPCO - FREEDOM SQUARE, LLC
Active
Parent organization
BROOKDALE SENIOR LIVING INC
Other names
Seminole Pavilion Rehabilitation & Nursing Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
BROOKDALE SENIOR LIVING INC
Authorized official
MR. MARK W OHLENDORF (PRESIDENT)
(414) 918-5000
Entity
Organization
Contact information
Practice address
10800 TEMPLE TERRACE, SEMINOLE, FL 33772-4736
(727) 398-0166
(727) 398-0188
Mailing address
10800 TEMPLE TERRACE, SEMINOLE, FL 33772-4736
(727) 398-0166
(727) 398-0188
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF14960961
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032423000
—
FL
Enumeration date
05/08/2006
Last updated
10/03/2014
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