Diversicare Leasing Corp.
Organization Active NPI Skilled Nursing Facility · Wauchula, FL
NPI 1376531673 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1376531673
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- SNF1196096 (FL)
- Legal business name
- DIVERSICARE LEASING CORP.
- Practice address
- 401 Orange PL
Wauchula, FL 33873-3417 - Phone
- (863) 773-3231
- Fax
- (863) 773-0959
- NPI assigned
- Oct 11, 2005
- Organization subpart
- No
Authorized official
- Name
- Raymond L. Tyler Jr.
- Title
- Executive Vice President and Coo
- Phone
- (615) 771-7575
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | SNF1196096 | FL | Yes |
Addresses
Primary practice location
401 Orange PL
Wauchula, FL 33873-3417
Mailing address
401 Orange PL
Wauchula, FL 33873-3417
Phone (863) 773-3231
Other names
- Hardee Manor Healthcare Center
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- Joanne Elizabeth Dilella
- Debra Doud
- Sandra C Driskell
- Drug Free Hardee, Inc.
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- Jennifer A Edwards
All providers in Wauchula, FL · Skilled Nursing Facility in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.