Organization
SALEM VILLAGES INCORPORATED HOLLY POINT PROPERTIES INC
Active
Other names
South Tampa Health and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVERN PATRICK HERZOG (PRESIDENT)
(386) 956-6956
Entity
Organization
Contact information
Practice address
4610 S MANHATTAN AVE, TAMPA, FL 33611-2308
(813) 839-5311
(813) 839-4728
Mailing address
4610 S MANHATTAN AVE, TAMPA, FL 33611-2308
(813) 839-5311
(813) 839-4728
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF30470961
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022491000
—
FL
Enumeration date
12/09/2005
Last updated
05/09/2012
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