Jacksonville Nursing & Rehab Center

LBN: Sovereign Healthcare Of Jacksonville, Llc
Jacksonville Nursing & Rehab Center is an health care organization with primary practice located at 4134 Dunn Ave , Jacksonville FL 32218-4410. 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. Sovereign Healthcare Of Jacksonville, Llc can be contacted via phone (904) 766-2297, or through Cronquist, R. Mark via phone (404) 574-2100.

Contact Information

Primary practice address
4134 Dunn Ave Jacksonville FL 32218-4410
Phone: (904) 766-2297
Fax: (904) 766-9166
Website:
Map and Directions
Authorized official contact:
Name: Cronquist, R. Mark
Phone: (404) 574-2100

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X SNF13500963 Florida

Profile Details

NPI number 1891782462
LBN Legal business name Sovereign Healthcare Of Jacksonville, Llc
DBA Doing business as Jacksonville Nursing & Rehab Center
Authorized official Cronquist, R. Mark
Entity Organization
Organization subpart 1 No
Enumeration date Sep 29th, 2005
Last updated Sep 24th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891782462 NPPES
Other V573P-6380 VA
MEDICAID 026349400 VA

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