| Organization Name: | WILLISTON REHABILITATION AND NURSING CENTER LLC |
| NPI Number: | 1053429266 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TZVI BOGOMILSKY (MEMBER) |
| Mailing Address: | 300 Nw 1st Ave Williston |
| State: | FL US |
| Postal Code: | 326962006 |
| Phone Number: | 3525283561 |
| Fax Number: | |
| NPI Enumeration Date: | 08/28/2006 |
| NPI Last Update Date: | 08/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BN1400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Nursing Facility Supplies |
| Taxonomy Definition: | |