<Unavail>

LBN: Shady Rest Care Pavilion, Inc.
<Unavail> is an health care organization with primary practice located at 2310 N Airport Rd , Fort Myers FL 33907-1426. 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. Shady Rest Care Pavilion, Inc. can be contacted via phone (239) 931-8401, or through Edwards, Weston R via phone (239) 931-8402.

Contact Information

Primary practice address
2310 N Airport Rd Fort Myers FL 33907-1426
Phone: (239) 931-8401
Fax: (239) 931-8453
Website:
Map and Directions
Authorized official contact:
Name: Edwards, Weston R
Phone: (239) 931-8402

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X SNF1497096 Florida

Profile Details

NPI number 1881681724
LBN Legal business name Shady Rest Care Pavilion, Inc.
DBA Doing business as <Unavail>
Authorized official Edwards, Weston R
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 5th, 2005
Last updated Sep 1st, 2016 - 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 1881681724 NPPES
Florida MEDICAID 021390000

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