NPIMap

Organization Active NPI

CCRC - South Port Square, LLC

Doing business as Harbour Health Center

  • Skilled Nursing Facility
  • Port Charlotte, FL
National Provider Identifier
1376957803
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CCRC - SOUTH PORT SQUARE, LLC
Doing business as
Harbour Health Center
Practice address
23013 Westchester Blvd
Port Charlotte, FL 33980-8448
Phone
(941) 625-1220
NPI assigned
Jun 12, 2014
Last updated
Jan 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Authorized official

Name
Noah Arce
Title
Administrator
Phone
(941) 625-1100

Specialties & licenses 1

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

Addresses

Primary practice location

23013 Westchester Blvd
Port Charlotte, FL 33980-8448

Mailing address

1920 Main St Ste 1200
Irvine, CA 92614-7230
Phone (949) 407-0700

Other names 1

  • Harbour Health Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141113000174 FL Part A Provider - Skilled Nursing Facility 0749402428 Practice locations: Port Charlotte, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376957803. Details of each certification follow.

Skilled nursing facility certification: CCN 105538

Legal name
CCRC - SOUTH PORT SQUARE, LLC
Doing business as
HARBOUR HEALTH CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jul 1, 1986
Last certification
Feb 8, 2024
Beds
120 (104 certified)
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Healthpeak/Life Care Services
Organization structure
LLCProprietary
Incorporated
May 2, 2014 in DE
Enrollment address
23013 Westchester Blvd
Port Charlotte, FL 33980-8448
Nursing home name
HARBOUR HEALTH CENTER
Affiliated entity
HEALTHPEAK PROPERTIES, INC.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Harbour Health CenterCCN 105538 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 1, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10478.6 residents per day on average
Chain
Healthpeak Properties, Inc.15 facilities in the chain
Penalties (3 years)
2Fines totaling $35,597

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

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 11

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

NameRoleSinceShare
Frank Russo Individual Managing Control - Governing BodySenior Vice President Jan 31, 2022
Brian C Hess Individual Operational/Managerial ControlExecutive Director Feb 1, 2020
Patrick Michael Cheng Individual Managing Control - Governing BodyVice President and Corp. Secretary Jan 31, 2022
HCP S-H 2014 Member LLC Organization, Irvine, CA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2020 100%
Blesilda H Olfato Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Apr 10, 2025
Life Care Services LLC Organization, Des Moines, IA LLC, Management services company, For-profit Operational/Managerial Control Feb 1, 2020
Adp of the SNF Apr 9, 2025
Healthpeak Op LLC Organization, Irvine, CA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 10, 2023 100%
S-H 2014 Opco TRS Inc Organization, Irvine, CA Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2020 100%
Noah Arce Individual Corporate OfficerAdministrator Dec 3, 2024
Operational/Managerial Control Dec 3, 2024
Adp of the SNF May 27, 2025
Healthpeak Properties Inc Organization, Irvine, CA Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2020 100%
CCRC Opco Ventures, LLC Organization, Irvine, CA LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 29, 2014 100%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 58

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

View all 58

Practitioners & affiliated clinicians

Affiliated clinicians 7

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": "1402531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768780800000",
    "number": "1376957803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 MAIN ST STE 1200",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926147230",
            "telephone_number": "949-407-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23013 WESTCHESTER BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339808448",
            "telephone_number": "941-625-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCRC - SOUTH PORT SQUARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-12",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A",
        "authorized_official_last_name": "ARCE",
        "authorized_official_first_name": "NOAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "941-625-1100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Harbour Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Harbour Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.