Organization
5065 WALLIS ROAD OPERATIONS LLC
Active
Other names
Renaissance Health and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH USSERY (VP)
(407) 571-1550
Entity
Organization
Contact information
Practice address
5065 WALLIS RD, WEST PALM BEACH, FL 33415-1947
(561) 689-1799
(561) 640-4603
Mailing address
5065 WALLIS RD, WEST PALM BEACH, FL 33415-1947
(561) 689-1799
(561) 640-4603
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1198096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004778700
—
FL
Enumeration date
12/27/2011
Last updated
11/27/2023
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