CCRC - LAKE PORT SQUARE, LLC
NPI 1073927331
Skilled Nursing Facility in Leesburg, FL
About Ccrc - Lake Port Square, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CCRC - LAKE PORT SQUARE, LLC (NPI 1073927331), doing business as Lake Port Square Health Center, is a healthcare organization registered as a skilled nursing facility in Leesburg, Florida and active in the NPI registry since June 2014. The organization lists Tristan Mohadeo, Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
Nursing Home Quality Ratings CMS Care Compare
Quality ratings, staffing and inspection history for Lake Port Square Health Center (CMS certification number 105705), from CMS Care Compare.
Lake Port Square Health Center
Nursing home · Leesburg, FLCMS Star Ratings
Staffing & Turnover
Inspections & Enforcement
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Ccrc - Lake Port Square, LLC's NPI number?
The NPI number for Ccrc - Lake Port Square, LLC is 1073927331. It was assigned to this organization in the NPPES registry on June 16, 2014. The provider is doing business as Lake Port Square Health Center.
Where is Ccrc - Lake Port Square, LLC located?
Ccrc - Lake Port Square, LLC is located at 701 Lake Port Blvd, Leesburg, FL 34748. The listed phone number is (352) 728-3366.
What is Ccrc - Lake Port Square, LLC's specialty?
The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.
Is Ccrc - Lake Port Square, LLC a Medicare-certified nursing home?
Yes. Lake Port Square Health Center is a Medicare-certified nursing home with 80 certified beds.
What quality rating does Ccrc - Lake Port Square, LLC have?
CMS rates Lake Port Square Health Center 1 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.
What insurance does Ccrc - Lake Port Square, LLC accept?
Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AvMed and Florida Blue (BlueCross BlueShield FL) and 2 other insurers list Ccrc - Lake Port Square, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Ccrc - Lake Port Square, LLC was last updated on January 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.