- Enrollment id
- O20241217001358
- Enrollment state
- FL
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1669211058
- Multiple npi flag
- N
- Ccn
- 106113
- Associate id
- 9335672146
- Organization name
- LEE HEALTH SYSTEM INC
- Doing business as name
- LMH SKILLED NURSING UNIT
- Incorporation date
- 2024-04-08
- Incorporation state
- FL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Nursing home provider name
- LEE MEMORIAL HOSPITAL SKILLED NURSING UNIT
- Address line 1
- 2776 CLEVELAND AVE
- Address line 2
- FL 3
- City
- FORT MYERS
- State
- FL
- Zip code
- 339015864