Organization
195 MATTIE M. KELLY BOULEVARD OPERATIONS LLC
Active
Other names
Destin Healthcare and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH USSERY (VP)
(407) 571-1550
Entity
Organization
Contact information
Practice address
195 MATTIE M KELLY BLVD, DESTIN, FL 32541-2811
(850) 654-4588
(850) 654-3944
Mailing address
195 MATTIE M KELLY BLVD, DESTIN, FL 32541-2811
(850) 654-4588
(850) 654-3944
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF16210961
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006110100
—
FL
Enumeration date
12/22/2011
Last updated
11/27/2023
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