Organization
NORTHERN JACKSONVILLE ACQUISITIONS, LLC
Active
Other names
Summer Brook Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL GREENWALD (OWNER/ MANAGER)
(786) 207-2108
Entity
Organization
Contact information
Practice address
5377 MONCRIEF RD, JACKSONVILLE, FL 32209-3159
(786) 207-2108
(866) 293-2100
Mailing address
5377 MONCRIEF RD, JACKSONVILLE, FL 32209-3159
(786) 207-2108
(866) 293-2100
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
FL
314000000X
Skilled Nursing Facility
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005978300
—
FL
01
—
10-5138
MEDICARE PTAN
FL
Enumeration date
09/10/2012
Last updated
12/20/2013
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