Organization
1851 ELKCAM BOULEVARD OPERATIONS LLC
Active
Other names
Deltona Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH USSERY (VP)
(407) 571-1550
Entity
Organization
Contact information
Practice address
1851 ELKCAM BLVD, DELTONA, FL 32725-3922
(386) 789-3769
(386) 789-6232
Mailing address
1851 ELKCAM BLVD, DELTONA, FL 32725-3922
(386) 789-3769
(386) 789-6232
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1125096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00438600
—
FL
Enumeration date
12/22/2011
Last updated
11/27/2023
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