Organization
ORANGE PARK EXTENDED CARE LLC
Active
Other names
The Terrace At Fleming Island
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DONNA J. MARSH (BOOKKEEPER)
(386) 255-1054
Entity
Organization
Contact information
Practice address
1125 FLEMING PLANTATION BLVD, ORANGE PARK, FL 32003-3389
(904) 245-7620
(904) 213-8338
Mailing address
1125 FLEMING PLANTATION BLVD, FLEMING ISLAND, FL 32003-3389
(904) 541-3500
(904) 213-8338
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
130471035
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028478500
—
FL
Enumeration date
03/17/2006
Last updated
06/12/2012
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