Organization
KISSIMMEE HEALTH CARE ASSOCIATES LLC
Active
Other names
Keystone Rehabilitation and Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
TYRUS D. HAWKINS (MANAGER)
(407) 847-2854
Entity
Organization
Contact information
Practice address
1120 W DONEGAN AVE, KISSIMMEE, FL 34741-2247
(407) 847-2854
(407) 994-4184
Mailing address
1120 W DONEGAN AVE, KISSIMMEE, FL 34741-2247
(407) 847-2854
(407) 994-4184
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
130471039
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031756000
—
FL
Enumeration date
05/24/2006
Last updated
09/27/2012
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