Search Icon


Provider Type Icon

INDIAN SHORE MANOR LLC NPI 1639587108


NPI Information

NPI: 1639587108
Provider Name: INDIAN SHORE MANOR, LLC
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
1611 INDIAN SHORE DR
CLERMONT, FL
ZIP 34711
Phone: (352) 404-8571
Get Directions

INDIAN SHORE MANOR, LLC is an assisted living facility in Clermont, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. INDIAN SHORE MANOR, LLC NPI is 1639587108. The provider is registered as an organization entity type.

The provider's business location address is:

1611 INDIAN SHORE DR
CLERMONT, FL
ZIP 34711-981
Phone: (352) 404-8571

The provider's authorized official is Merita Mason .
The authorized official title is Administrator and has the following contact phone number (718) 344-3828.

The enumeration date for this NPI number is 7/29/2014 and was last updated on 7/29/2014.


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
1310400000XAssisted Living FacilityAL12464FLORIDAYes

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: 1/10/2023

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.