3001 Palm Coast Parkway Operations LLC

Organization Active NPI Skilled Nursing Facility · Palm Coast, FL

NPI 1083983720 · NPPES record last updated Nov 27, 2023

Key facts

NPI
1083983720
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
SNF130470968 (FL)
Legal business name
3001 PALM COAST PARKWAY OPERATIONS LLC
Practice address
3001 Palm Coast Pkwy SE
Palm Coast, FL 32137-8209
Phone
(386) 446-6060
Fax
(386) 446-6033
NPI assigned
Dec 27, 2011
Organization subpart
No

Authorized official

Name
Kenneth Ussery
Title
VP
Phone
(407) 571-1550

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X SNF130470968 FL Yes

Addresses

Primary practice location

3001 Palm Coast Pkwy SE
Palm Coast, FL 32137-8209

Mailing address

3001 Palm Coast Pkwy SE
Palm Coast, FL 32137-8209
Phone (386) 446-6060

Other identifiers

IdentifierTypeStateIssuer
004386400MedicaidFL

Other names

  • Grand Oaks Health and Rehabilitation Center Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other

Other providers in Palm Coast, FL

All providers in Palm Coast, FL · Skilled Nursing Facility in Florida

Sources for this page

Verify at the official NPI Registry.