- Enrollment id
- O20210604002752
- Enrollment state
- DE
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1922689249
- Multiple npi flag
- N
- Ccn
- 085004
- Associate id
- 2365841749
- Organization name
- SPRINGS REHABILITATION AT BRANDYWINE LLC
- Doing business as name
- CORAL SPRINGS REHEB AND HEALTHCARE CENTER
- Incorporation date
- 2021-03-01
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- CORAL SPRINGS REHAB & HEALTHCARE
- Affiliation entity name
- PRESTIGE HEALTHCARE ADMINISTRATIVE SERVICES
- Affiliation entity id
- 418
- Address line 1
- 505 GREENBANK RD
- City
- WILMINGTON
- State
- DE
- Zip code
- 198083164