Organization
CCRC OPCO-FREEDOM SQUARE, LLC
Active
Other names
Seminole Pavillion Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY MILLER (CEO/PRESIDENT)
(949) 407-0700
Entity
Organization
Contact information
Practice address
10800 TEMPLE TER, SEMINOLE, FL 33772-4736
(727) 398-0166
Mailing address
1920 MAIN ST STE 1200, IRVINE, CA 92614-7230
(949) 407-0700
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
06/25/2014
Last updated
02/10/2021
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