Organization · Type 2 NPI

CCRC - Lake Port Square, LLC

Skilled Nursing Facility · Leesburg, FL

NPI number 1073927331 Active

Practice location

701 Lake Port Blvd
Leesburg, FL 34748-7674

Call (352) 728-3366 Map

Mailing address

1920 Main St Ste 1200
Irvine, CA 92614-7230

Specialties and licenses

TaxonomyCodeLicense
Skilled Nursing Facility Primary 314000000XNone listed

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

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About NPI 1073927331

CCRC - Lake Port Square, LLC's National Provider Identifier is 1073927331, issued on Jun 16, 2014. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Leesburg, FL. The record was last updated on Jan 19, 2026.