Organization
TEAM REGENCY HEALTHCARE, LLC
Active
Parent organization
SOVEREIGN HEALTHCARE HOLDINGS, LLC
Other names
Fort Myers Rehabilitation Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOVEREIGN HEALTHCARE HOLDINGS, LLC
Authorized official
MR. R. MARK CRONQUIST (MANAGER)
(404) 574-2100
Entity
Organization
Contact information
Practice address
7173 CYPRESS DR, FORT MYERS, FL 33907-2938
(239) 936-0203
(239) 936-9544
Mailing address
5887 GLENRIDGE DR, SUITE 150, ATLANTA, GA 30328-5574
(404) 574-2100
(404) 574-2105
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
07/18/2014
Last updated
08/14/2014
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