Provider Type Icon

TOTAL CARE MANOR INC NPI 1871745265


NPI Information

NPI: 1871745265
Provider Name: TOTAL CARE MANOR, INC

Doing Business As: HORIZON ALF

Classification: Assisted Living Facility - 3104A0625X
Entity Type: Organization

Specialization: Assisted Living, Mental Illness

CLIA Number: 10D2198911

Address:
1490 NW 21 STREET
FORT LAUDERDALE, FL
ZIP 33311
Phone: (954) 523-1543
Get Directions

TOTAL CARE MANOR, INC is an assisted living and mental illness assisted living facility in Fort Lauderdale, 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. TOTAL CARE MANOR, INC NPI is 1871745265. The provider is registered as an organization entity type.
The provider Is Doing Business As Horizon Alf.

The provider's business location address is:

1490 NW 21 STREET
FORT LAUDERDALE, FL
ZIP 33311
Phone: (954) 523-1543
Fax: (954) 527-0505

The provider's authorized official is Jason Kissoonlal .
The authorized official title is President and has the following contact phone number (954) 523-1543.

The CLIA number assigned to this NPI record is 10D2198911 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/16/2008 and was last updated on 8/26/2020.


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 IllnessAL8595FLORIDAYes

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
1141923400MEDICAIDFLORIDA

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.