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MANDEVILLE MANOR HEALTH SYSTEMS INC. NPI 1427594944


NPI Information

NPI: 1427594944
Provider Name: MANDEVILLE MANOR HEALTH SYSTEMS INC.
Classification: Assisted Living Facility - 3104A0625X
Entity Type: Organization

Specialization: Assisted Living, Mental Illness

Address:
40 PONCE DELEON DR
PALM COAST, FL
ZIP 32164
Phone: (386) 586-5654
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MANDEVILLE MANOR HEALTH SYSTEMS INC. is an assisted living and mental illness assisted living facility in Palm Coast, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. MANDEVILLE MANOR HEALTH SYSTEMS INC. NPI is 1427594944. The provider is registered as an organization entity type.

The provider's business location address is:

40 PONCE DELEON DR
PALM COAST, FL
ZIP 32164-910
Phone: (386) 586-5654
Fax: (386) 586-5440

The provider's authorized official is Margaret Mclarty .
The authorized official title is Chief Financial Officer and has the following contact phone number (386) 679-4867.

The enumeration date for this NPI number is 1/7/2017 and was last updated on 1/7/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13104A0625XAssisted Living FacilityAssisted Living, Mental Illness00000000FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1676845896MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.