- Enrollment id
- O20080122000176
- Enrollment state
- FL
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1518961226
- Multiple npi flag
- N
- Ccn
- 105408
- Associate id
- 2264513837
- Organization name
- SENIOR HEALTH-TREASURE ISLE, LLC
- Doing business as name
- TREASURE ISLE CARE CENTER
- Incorporation date
- 2000-11-20
- Incorporation state
- FL
- Organization type structure
- LLC
- Proprietary nonprofit
- N
- Nursing home provider name
- TREASURE ISLE CARE CENTER
- Affiliation entity name
- SENIOR HEALTH SOUTH
- Affiliation entity id
- 729
- Address line 1
- 1735 N TREASURE DR
- City
- NORTH BAY VILLAGE
- State
- FL
- Zip code
- 331414216