Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ccrc - Lake Port Square, LLC

Organization Skilled Nursing Facility · NPI 1073927331

Ccrc - Lake Port Square, LLC is a Skilled Nursing Facility in Leesburg, Florida. Medicare rates this nursing home 3 out of 5. Registered with an NPI since 2014.

CMS rating
3 of 5
In the registry since
2014
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

CMS quality rating

3 out of 5 — official nursing home rating from CMS Care Compare (CCN 105705)
Health inspection3.0 / 5
Staffing3.0 / 5
Quality measures3.0 / 5
OwnershipFor profit - Limited Liability company

Practice location Address checks out

701 Lake Port Blvd
Leesburg, FL 34748-7674
Phone: (352) 728-3366
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X

Record details

NPI number1073927331
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tristan Mohadeo — Administrator · (352) 728-8525
Other names Lake Port Square Health Center
NPI enumeratedJune 16, 2014
Last updated in NPPESJanuary 19, 2026
Certification dateJanuary 19, 2026
Mailing address1920 Main St Ste 1200, Irvine, CA 92614-7230

Other providers in Leesburg