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Organization

803 OAK STREET OPERATIONS LLC

Active
Other names
Governor's Creek Health and Rehabilitation
Organization subpart
No

Provider details

NPI number
Authorized official
KENNETH USSERY (VP)
(407) 571-1550
Entity
Organization

Contact information

Practice address
803 OAK ST, GREEN COVE SPRINGS, FL 32043-4317
(904) 284-5606
(904) 284-0392
Mailing address
803 OAK ST, GREEN COVE SPRINGS, FL 32043-4317
(904) 284-5606
(904) 284-0392

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1181096
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004387500
FL
Enumeration date
12/27/2011
Last updated
11/27/2023
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