Organization
LTCSP PLANT CITY, LLC
Active
Other names
Community Convalescent Center
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD JAFFE (PRESIDENT)
(215) 346-6454
Entity
Organization
Contact information
Practice address
2202 W OAK AVE, PLANT CITY, FL 33563-7222
(813) 754-3761
(813) 754-5301
Mailing address
1675 PALM BEACH LAKES BLVD, SUITE 900, WEST PALM BEACH, FL 33401
(561) 801-7600
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1099096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028191300
—
FL
Enumeration date
06/16/2005
Last updated
12/21/2013
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