Organization
INNOVATIVE HEALTH CARE PROPERTIES D B A SUMMER BROOK HEALTH CARE CENTE
Active
Other names
Innovative Health Care Properties
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEWAYNE K HARVEY (ADMINISTRATOR)
(904) 768-1506
Entity
Organization
Contact information
Practice address
5377 MONCRIEF RD, JACKSONVILLE, FL 32209-3159
(904) 768-1506
(904) 766-1772
Mailing address
5377 MONCRIEF RD, JACKSONVILLE, FL 32209-3159
(904) 768-1506
(904) 766-1772
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1132096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M52
HUMANA PROVIDER NUMBER
FL
Enumeration date
10/26/2005
Last updated
08/22/2020
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