Organization
DEEP CREEK RNC, LLC
Active
Other names
Port Charlotte Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE R PARTEE (VICE PRESIDENT OF FINANCE)
(404) 406-4150
Entity
Organization
Contact information
Practice address
25325 RAMPART BLVD, PORT CHARLOTTE, FL 33983
(941) 629-7466
(941) 629-9053
Mailing address
25325 RAMPART BLVD, PORT CHARLOTTE, FL 33983-6404
(941) 629-7466
(941) 629-9053
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF14260961
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0319325 00
—
FL
01
—
V516P-6820
VA
—
Enumeration date
09/29/2005
Last updated
01/15/2025
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