Fort Walton Rehabilitation Center, Llc
LBN: Fort Walton Rehabilitation Center, Llc
Fort Walton Rehabilitation Center, Llc is an health care organization with primary practice located at 1 L B J Sr Dr , Fort Walton Beach FL 32547-1163. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty.
Fort Walton Rehabilitation Center, Llc can be contacted via phone (850) 863-2066, or through Cronquist, R. Mark via phone (404) 574-2100.
Contact Information
Primary practice address
1 L B J Sr Dr
Fort Walton Beach FL 32547-1163
Phone: (850) 863-2066
Fax: (850) 863-9006
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Skilled Nursing Facility | 314000000X | Florida | |
| Nursing & Custodial Care Facilities / Skilled Nursing Facility | 314000000X | SNF11610951 | Florida |
Profile Details
| NPI number | 1962788646 |
|---|---|
| LBN Legal business name | Fort Walton Rehabilitation Center, Llc |
| DBA Doing business as | |
| Authorized official | Cronquist, R. Mark |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 26th, 2011 |
| Last updated | Sep 29th, 2014 - about 10 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962788646 | NPPES |
| Florida | MEDICAID | 004488800 |
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