Organization
THE PAVILION AT CRESCENT LAKE FOR NURSING AND REHABILITATION, LLC
Active
Other names
The Pavilion at Crescent Lake
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAEL A MOERMAN (MANAGING MEMBER)
(516) 865-1500
Entity
Organization
Contact information
Practice address
100 N LAKE ST, CRESCENT CITY, FL 32112-2620
(516) 865-1500
Mailing address
1 VALLEY GREENS DR, VALLEY STREAM, NY 11581-3634
(516) 865-1500
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/12/2021
Last updated
03/12/2021
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