Organization
SOUTH CAMPUS FACILITY INC
Active
Other names
South Campus 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
715 E DIXIE AVE, LEESBURG, FL 34748-5926
(352) 728-3020
Mailing address
4302 HOLLYWOOD BLVD, #369, HOLLYWOOD, FL 33021-6635
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF12910961
FL
Other
Enumeration date
04/28/2015
Last updated
05/05/2015
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