Organization · Type 2 NPI

CCRC - South Port Square, LLC

Skilled Nursing Facility · Port Charlotte, FL

NPI number 1376957803 Active

Practice location

23013 Westchester Blvd
Port Charlotte, FL 33980-8448

Call (941) 625-1220 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 1376957803

CCRC - South Port Square, LLC's National Provider Identifier is 1376957803, issued on Jun 12, 2014. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Port Charlotte, FL. The record was last updated on Jan 19, 2026.