Organization
BELLEAIR EAST HCC, LLC
Active
Other names
Belleair Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL B. KELLETT (AS SOLE MEMBER OF SBK CAPITAL LLC)
(404) 233-7048
Entity
Organization
Contact information
Practice address
1150 PONCE DE LEON BLVD, CLEARWATER, FL 33756-1041
(727) 585-5491
(727) 584-5893
Mailing address
1150 PONCE DE LEON BLVD, CLEARWATER, FL 33756-1041
(727) 585-5491
(727) 584-5893
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF10480962
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026452100
—
FL
01
—
V516P-6819
VA
—
Enumeration date
09/29/2005
Last updated
10/19/2009
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