SOVEREIGN HEALTHCARE OF ATLANTIC SHORES, LLC
Nursing at Stack Blvd, Melbourne, FL

License number
Florida SNF16420951
Category
Nursing
Type
Skilled Nursing Facility
Owner
Name: MR. R. MARK CRONQUIST
Title: MANAGER
Phone: (404) 574-2100
Address
Address 2
4251 Stack Blvd, Melbourne, FL 32901
5887 Glenridge Dr SUITE 150, Atlanta, GA 30328
National Provider ID: 1831186477
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Sovereign Healthcare of Atlantic Shores, LLC

Melbourne, FL  -  Atlanta, GA

Industry:
Skilled Nursing Care Facility
Registration:
Jul 15, 2003
Phone:
(321) 953-2219 (Phone)
Addresses:
4251 Stack Blvd, Melbourne, FL 32901
5887 Glenridge Dr NE, Atlanta, GA 30328
State ID:
M03000002353
Business type:
Foreign Limited Liability
Manager, Managing Members:
Richard Owens (Director Of Social),Mara Flaherty (Office Manager),John Notermann (Manager),...
Agent:
National Corporate Research, Ltd., Inc

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