Organization
ST PETERSBURG NURSING HOME, LLC
Active
Other names
Jacaranda Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE BURDETTE (DIRECTOR OF FINANCE)
(423) 308-1845
Entity
Organization
Contact information
Practice address
4250 66TH ST N, KENNETH CITY, FL 33709-4918
(727) 546-2405
Mailing address
4250 66TH ST N, KENNETH CITY, FL 33709-4918
(727) 546-2405
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1252096
FL
Other
Enumeration date
10/31/2005
Last updated
08/22/2020
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