CCRC OPCO-FREEDOM SQUARE, LLC (NPI# 1780098202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780098202 |
| Entity Type | Organization |
| Organization Name | CCRC OPCO-FREEDOM SQUARE, LLC |
| Other Organization Name | FREEDOM SQUARE HEALTH CARE CENTER |
| Practice Address |
10801 Johnson Blvd Seminole FL 33772-4746 |
| Mailing Address |
1920 Main St Ste 1200 Irvine CA 92614-7230 |
| Practice Telephone | 7273980166 |
| Practice Fax Number | 7273980188 |
| Mailing Telephone | 9494070700 |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2020-07-22 |
| Authorized Official Name | JEFFREY MILLER (CEO/PRESIDENT) |
| Authorized Official Telephone | 9494070700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Freedom Square Health Care Center | Doing Business As Name - Organization |
| Freedom Square Rehabilitation and Nursing Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225443583 | Ccrc Opco-freedom Square, LLC | Skilled Nursing Facility | 10800 Temple Ter, Seminole, FL 33772-4736 | 2014-06-25 |
| Street Address |
10801 JOHNSON BLVD |
| City | SEMINOLE |
| State | FL |
| Zip Code | 33772-4746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033168992 | Ccrc Opco - Freedom Square, LLC | Skilled Nursing Facility | 10801 Johnson Blvd, Seminole, FL 33772-4746 | 2006-05-09 |
| 1841693686 | Chelsie Miller | Occupational Therapist | 10801 Johnson Blvd, Seminole, FL 33772-4746 | 2014-10-08 |
| 1518166131 | Arc Freedom Square LLC | Assisted Living Facility | 10801 Johnson Blvd, Seminole, FL 33772-4746 | 2007-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245765205 | Capstone Eye Care Group of Florida LLC | Eyewear Supplier (Equipment, not the service) | 7855 113th St Bldg P-2, Suite A, Seminole, FL 33772 | 2017-04-27 |
| 1922453067 | Donna Malkovich | Nurse Practitioner | 11925 Mandarin Ct, Seminole, FL 33772 | 2016-04-26 |
| 1518259209 | Dorca N. May | Nurse's Aide | 11428 - 63 Ave N, Seminole, FL 33772 | 2011-05-12 |
| 1467753681 | Anthony J. Auletta, Jr. D.m.d., Pa | Dentist | 8277 113th Street N, Seminole, FL 33772 | 2010-11-04 |
| 1346559481 | Tiffany Jane Marie Bishop | Physical Therapist | 11224 Park Blvd., N, Cora Rehabilitation, Seminole, FL 33772 | 2010-10-06 |
| 1235442997 | Cynthia Renee Bouchard | Student in an Organized Health Care Education/Training Program | 9200 113th St. N., Seminole, FL 33772 | 2010-07-22 |
| 1851603591 | William Daily | Dentist | 9200 113th St N, Seminole, FL 33772 | 2010-07-10 |
| 1427370295 | Teresa Ann Skinner | Counselor | 7130 Seminole Blvd., Seminole Professional Centre, Seminole, FL 33772 | 2010-02-22 |
| 1922257120 | Jennifer Henkel Johnson | Dentist | 9951 Seminole Blvd, Seminole, FL 33772 | 2008-09-11 |
| 1528233970 | Joann Carol Horianopoulos | Physical Therapy Assistant | 7388 121st Way North, Seminole, FL 33772 | 2008-04-28 |
| Find all providers in zip 33772 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225443583 | Ccrc Opco-freedom Square, LLC | Skilled Nursing Facility | 10800 Temple Ter, Seminole, FL 33772-4736 | 2014-06-25 |
| 1780921155 | Seminole Health Care LLC | Skilled Nursing Facility | 1200 E Wrangler Blvd, Seminole, OK 74868-3512 | 2013-01-05 |
| 1194765693 | Tandem Health Care of St. Petersburg, Inc. | Skilled Nursing Facility | 9393 Park Blvd, Seminole, FL 33777-4140 | 2006-06-07 |
| 1033168992 | Ccrc Opco - Freedom Square, LLC | Skilled Nursing Facility | 10801 Johnson Blvd, Seminole, FL 33772-4746 | 2006-05-09 |
| 1104875152 | Ccrc Opco - Freedom Square, LLC | Skilled Nursing Facility | 10800 Temple Terrace, Seminole, FL 33772-4736 | 2006-05-08 |
| 1932173010 | Lifestyles 1 Healthcare LLC | Skilled Nursing Facility | 11300 110th Ave, Seminole, FL 33778-3711 | 2006-02-15 |
| 1700809662 | St Petersburg Facility Operations, LLC | Skilled Nursing Facility | 9393 Park Blvd, Seminole, FL 33777-4140 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306444708 | Center for Comprehensive Services, Inc. | Skilled Nursing Facility | 2411 Clement Rd, Lutz, FL 33549-5552 | 2020-10-16 |
| 1114530227 | Jupiter Rehab and Health Center LLC | Skilled Nursing Facility | 650 Pioneer Rd # 5, Jupiter, FL 33458-8834 | 2020-08-28 |
| 1821601089 | Wellington Rehab and Health Center, LLC | Skilled Nursing Facility | 10330 Nu Vista Ave, Wellington, FL 33414 | 2020-08-27 |
| 1043822349 | Oaks of Kissimmee Operations LLC | Skilled Nursing Facility | 320 N. Mitchell St, Kissimmee, FL 34741-4447 | 2020-08-18 |
| 1720690027 | Brynwood Operations LLC | Skilled Nursing Facility | 1656 S Jefferson St, Monticello, FL 32344-1652 | 2020-08-18 |
| 1326668120 | Key West Nursing Home Propco LLC | Skilled Nursing Facility | 5860 College Road, Key West, FL 33040 | 2020-04-21 |
| 1740800655 | Javara Troupe | Skilled Nursing Facility | 10043 Victory Gallop Loop, Ruskin, FL 33573-6744 | 2020-04-21 |
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1053944116 | Pruitthealth - Southwood, LLC | Skilled Nursing Facility | 2301 Bluff Oak Way, Tallahassee, FL 32311-6161 | 2020-02-18 |
| 1992336895 | Dolphin Pointe Health Care, LLC | Skilled Nursing Facility | 5355 Dolphin Point Rd., Jacksonville, FL 32211 | 2020-01-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.