Macclenny Nursing & Rehab Center

LBN: Sovereign Healthcare Of Macclenny, Llc
Macclenny Nursing & Rehab Center is an health care organization with primary practice located at 755 S 5Th St , Macclenny FL 32063-2685. 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 Macclenny, Llc can be contacted via phone (904) 259-4873, or through Cronquist, R. Mark via phone (404) 574-2100.

Contact Information

Primary practice address
755 S 5Th St Macclenny FL 32063-2685
Phone: (904) 259-4873
Fax: (904) 259-5381
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 SNF1222096 Florida

Profile Details

NPI number 1720075351
LBN Legal business name Sovereign Healthcare Of Macclenny, Llc
DBA Doing business as Macclenny 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 12 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 1720075351 NPPES
Other V573P-6392 VA
MEDICAID 026351600 VA

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