- Enrollment id
- O20211022001324
- Enrollment state
- FL
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1386249167
- Multiple npi flag
- N
- Ccn
- 106034
- Associate id
- 2264820307
- Organization name
- JACKSON REHAB OPERATIONS, LLC
- Doing business as name
- JACKSON GARDENS HEALTH AND REHABILITATION CENTER
- Incorporation date
- 2020-10-02
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- JACKSON GARDENS HEALTH AND REHABILITATION CENTER
- Affiliation entity name
- ONYX HEALTH
- Affiliation entity id
- 385
- Address line 1
- 1861 NW 8TH AVE
- City
- MIAMI
- State
- FL
- Zip code
- 331361115