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)CodeLicenseStatePrimary
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 Doing business as

Other providers in Wauchula, FL

All providers in Wauchula, FL · Skilled Nursing Facility in Florida

Sources for this page

Verify at the official NPI Registry.