LP Graceville LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1253096 Issued in FL

Legal business name

LP GRACEVILLE LLC

Doing business as

Signature HealthCARE of North Florida

Practice address

1083 Sanders Ave
Graceville, FL 32440-1854

Phone

(850) 263-4447

Fax

(850) 263-4201

NPI assigned

Aug 5, 2007

Last updated

Oct 15, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

LP CR HOLDINGS LLCAs reported in NPPES

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

Authorized official

Name

Mr. John Harrison

Title

Cfo

Phone

(502) 568-7800

Specialties & licenses 1

Addresses

Other names 1

• Signature HealthCARE of North Florida Doing business as

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287100800000",
    "number": "1740471010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 BLUEGRASS PARKWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992361",
            "telephone_number": "502-568-7800",
            "fax_number": "502-568-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1083 SANDERS AVE",
            "city": "GRACEVILLE",
            "state": "FL",
            "postal_code": "324401854",
            "telephone_number": "850-263-4447",
            "fax_number": "850-263-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LP GRACEVILLE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LP CR HOLDINGS LLC",
        "enumeration_date": "2007-08-05",
        "last_updated": "2010-10-15",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-568-7800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1253096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Signature HealthCARE of North Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jackson County Senior Citizens, Inc.
• Kristian Joy Vance Jones
• Belinda D Jordan, LMHC
• Galina Kats-Kagan
• Payton Brooke Kressman, APRN
• Amber T McDowell, RN
• Tremia Montgomery
• Terry Emmitt Nichols, DMD
• William Barry Nolin, M.D.
• Northwest Florida Healthcare, Inc. (Graceville Clinic - Northwest Florida Community Hospital)

• Skilled Nursing Facility in Graceville, FL
• Providers in Graceville, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.