Ccrc - Lake Port Square, LLC
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.
CMS quality rating
| Health inspection | 3.0 / 5 |
|---|---|
| Staffing | 3.0 / 5 |
| Quality measures | 3.0 / 5 |
| Ownership | For profit - Limited Liability company |
Practice location Address checks out
701 Lake Port BlvdLeesburg, FL 34748-7674
Phone: (352) 728-3366
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Skilled Nursing Facility (primary) | Taxonomy 314000000X |
|---|
Record details
| NPI number | 1073927331 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Tristan Mohadeo — Administrator · (352) 728-8525 |
| Other names | Lake Port Square Health Center |
| NPI enumerated | June 16, 2014 |
| Last updated in NPPES | January 19, 2026 |
| Certification date | January 19, 2026 |
| Mailing address | 1920 Main St Ste 1200, Irvine, CA 92614-7230 |
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