NPIMap

Organization Active NPI

Port St. Lucie Operations, LLC

Doing business as Life Care Center of Port St. Lucie

  • Skilled Nursing Facility
  • Port St Lucie, FL
National Provider Identifier
1104361138
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PORT ST. LUCIE OPERATIONS, LLC
Doing business as
Life Care Center of Port St. Lucie
Practice address
3720 SE Jennings Rd
Port St Lucie, FL 34952-7701
Phone
(772) 398-8080
Fax
(772) 398-9365
NPI assigned
Dec 29, 2016
Last updated
Jul 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cindy Cross
Title
Assistant Secretary
Phone
(423) 473-5867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

3720 SE Jennings Rd
Port St Lucie, FL 34952-7701

Mailing address

3001 Keith St NW
Cleveland, TN 37312-3713
Phone (423) 473-5751

Other names 1

  • Life Care Center of Port St. Lucie Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170411001497 FL Part A Provider - Skilled Nursing Facility 1759667504 Practice locations: Port St Lucie, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104361138. Details of each certification follow.

Skilled nursing facility certification: CCN 106012

Legal name
PORT ST. LUCIE OPERATIONS LLC
Doing business as
LIFE CARE CENTER OF PORT ST. LUCIE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 9, 1999
Last certification
Aug 8, 2024
Beds
123
Ownership / control type
Corporation
Organization structure
LLC
Enrollment address
3720 SE Jennings Rd
Port St Lucie, FL 34952-7701
Nursing home name
LIFE CARE CENTER OF PORT SAINT LUCIE
Affiliated entity
LIFE CARE CENTERS OF AMERICA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Life Care Center of Port Saint LucieCCN 106012 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Sep 9, 1999
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
123113.4 residents per day on average
Chain
Life Care Centers of America194 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Life Care Center of Port St Lucie2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Organization, Cleveland, TN LLC, For-profit Adp of the SNF Dec 16, 2015
Forrest L Preston Individual 5% Or Greater Indirect Ownership Interest Aug 24, 2015 100%
Operational/Managerial Control Aug 24, 2015
Adp of the SNF Dec 16, 2015
Indirect Ownership Interest Aug 24, 2015 100%
Terry Henry Individual Corporate OfficerAssistant Treasurer of MGMT. Co. Jun 1, 2017
Slyvia Hickman Individual Operational/Managerial Control Nov 13, 2023
Managing Control - Governing BodyDirector of Nursing Nov 13, 2023
Todd Fletcher Individual Operational/Managerial Control May 1, 2021
Aubrey Preston Individual Operational/Managerial Control Nov 27, 2024
Organization, Cleveland, TN LLC, For-profit Adp of the SNF Feb 12, 2025
Yohanna Deno Individual Operational/Managerial Control Jul 1, 2022
Adp of the SNF Mar 7, 2025
Joan E Thurmond Individual Corporate OfficerAssist. Secretary of MGMT. Co. Jun 1, 2017
Cindy S Cross Individual Corporate OfficerVP / Assist. Secretary of MGMT. Co. Jun 1, 2017
Richard Swanker Individual Operational/Managerial Control Jan 1, 2022
Life Care Centers of America, Inc. Organization, Cleveland, TN Corporation, Management services company, For-profit, Chain home office, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 24, 2015 100%
Operational/Managerial Control Aug 24, 2015 100%
Adp of the SNF Dec 16, 2015
Aaron Preston Individual Operational/Managerial Control Jan 3, 2005
Managing Control - Governing BodyDivision Vice President Jan 3, 2005
Lisa M Lay Individual Operational/Managerial Control Apr 24, 2017
James Ziegler Individual Operational/Managerial Control Aug 24, 2015
Jeffrey Valdez Individual Operational/Managerial Control Jun 20, 2022
Managing Control - Governing BodyAdministrator Jun 20, 2022
Adp of the SNF Feb 27, 2025

Owners & managing parties with NPI records 26

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 26

Facilities with the same owner 193

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 193

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1482969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783900800000",
    "number": "1104361138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 KEITH ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123713",
            "telephone_number": "423-473-5751",
            "fax_number": "423-339-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 SE JENNINGS RD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527701",
            "telephone_number": "772-398-8080",
            "fax_number": "772-398-9365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT ST. LUCIE OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-29",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "423-473-5867"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "284 Merchant St",
            "city": "Ste Genevieve",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636701610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Life Care Center of Port St. Lucie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.