Organization
BREVARD HMA NURSING HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE HOLTSFORD (AUTHORIZED OFFICIAL)
(615) 465-7466
Entity
Organization
Contact information
Practice address
8050 SPYGLASS HILL RD, VIERA, FL 32940-7983
(321) 752-1000
Mailing address
8050 SPYGLASS HILL RD, VIERA, FL 32940-7983
(321) 752-1000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF16320961
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025347200
—
FL
Enumeration date
04/28/2006
Last updated
01/30/2014
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