195 Mattie M. Kelly Boulevard Operations LLC
NPI #1336418102 in Destin, Florida
Provider Information
- NPI Number
- 1336418102
- Entity Type
- Organization
- Organization Name
- 195 Mattie M. Kelly Boulevard Operations LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Dec 22, 2011
- Last Updated
- Nov 27, 2023
Practice Location
Authorized Official
- Name
- KENNETH USSERY
- Title
- VP
- Phone
- (407) 571-1550
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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