Organization
COOPER CREEK FACILITY LLC
Active
Other names
Cooper Creek Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BLEICH (AUTHORIZED REPRESENTATIVE)
(845) 641-8314
Entity
Organization
Contact information
Practice address
5381 DESOTO ROAD, SARASOTA, FL 34235
(941) 355-6111
Mailing address
400 RELLA BLVD STE 200, MONTEBELLO, NY 10901-4239
(845) 490-6060
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
FL
Other
Enumeration date
04/22/2018
Last updated
04/22/2018
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