EDENVILLE MANOR LLC (NPI# 1467726091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467726091 |
| Entity Type | Organization |
| Organization Name | EDENVILLE MANOR LLC |
| Practice Address |
721 Edenville Ave Clearwater FL 33764-6339 |
| Practice Telephone | 7277267242 |
| Practice Fax Number | 7277267211 |
| Mailing Telephone | 7277267242 |
| Mailing Fax Number | 7277267211 |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2012-02-29 |
| Authorized Official Name | MR. PROSPER K BONUEDIE (ADMINISTRATOR) |
| Authorized Official Telephone | 7277267242 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL 11968190 | FL | Nursing & Custodial Care Facilities |
| Street Address |
721 EDENVILLE AVE |
| City | CLEARWATER |
| State | FL |
| Zip Code | 33764-6339 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649891904 | Jennifer Rose Whealey | Social Worker | 1437 S. Belcher Rd., Clearwater, FL 33764 | 2020-04-28 |
| 1831740521 | Kasey Coffin | Pharmacist | 1938 Sever Drive, Clearwater, FL 33764 | 2019-09-24 |
| 1053876649 | Jacqueline Armstead | Community Health Worker | 11270 Us Hwy 19 N, Bldg#3 Apt#108, Clearwater, FL 33764 | 2019-02-07 |
| 1215419791 | Linda Susanne Blake | Social Worker | 19029 Us Highway 19 North, Villa 22d, Clearwater, FL 33764 | 2018-08-31 |
| 1770002651 | American Advanced Senior Care LLC | Assisted Living Facility | 2298 Bellaire Road, Clearwater, FL 33764 | 2017-09-12 |
| 1366969016 | Ryan Black | Social Worker | 2100 Nursery Rd. E18, Clearwater, FL 33764 | 2017-08-24 |
| 1710370366 | Susan Arleen Gaddy | Dietitian, Registered | 1340 Weber Drive, Clearwater, FL 33764 | 2015-03-06 |
| 1699108373 | Lori L Fehr | Physician Assistant | 18167 U.S. Highway 19n, Suite 650, Emcare Attn: Laurie, Clearwater, FL 33764 | 2013-08-16 |
| 1306287628 | A Tender Touch In Home Services | In Home Supportive Care | 2159 Nursery Rd #314, Clearwater, FL 33764 | 2013-07-15 |
| 1174884134 | Applied Behavior Approaches of Tampa Bay Inc. | Community/Behavioral Health | 2225 Nursery Rd, Apt 13-203, Clearwater, FL 33764 | 2012-06-06 |
| Find all providers in zip 33764 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073156279 | Lots Care Company Inc | Assisted Living Facility | 202 Cove Ct, Clearwater, FL 33756-1728 | 2019-10-21 |
| 1538626064 | Gv Clearwater, LLC | Assisted Living Facility | 2750 Drew St, Clearwater, FL 33759-3034 | 2019-02-20 |
| 1770002651 | American Advanced Senior Care LLC | Assisted Living Facility | 2298 Bellaire Road, Clearwater, FL 33764 | 2017-09-12 |
| 1013313246 | Sunset Villa Retirement Home | Assisted Living Facility | 2308 Americus Dr, Clearwater, FL 33763-4503 | 2014-11-17 |
| 1023411246 | Heritage House Retirement Home | Assisted Living Facility | 1810 S Belcher Rd, Clearwater, FL 33764-6602 | 2014-10-01 |
| 1316352172 | Fi-highland Pines LLC | Assisted Living Facility | 1520 Jeffords St, Clearwater, FL 33756-4449 | 2014-06-30 |
| 1710302526 | Pinnacle Health Facilities Xxxii Lp | Assisted Living Facility | 440 N 4th St, Clearwater, KS 67026-9708 | 2014-03-03 |
| 1295159903 | Hillside Gardens Inc | Assisted Living Facility | 3434 Zara Way, Clearwater, FL 33761-1225 | 2014-02-17 |
| 1245654706 | Smith Health Care Properties - Clearwater | Assisted Living Facility | 2057 Edgewater Dr, Clearwater, FL 33755-1028 | 2014-02-04 |
| 1134550718 | Lovely Care Manor LLC | Assisted Living Facility | 2869 Sarah Dr, Clearwater, FL 33759-2010 | 2013-12-06 |
| Find all providers in CLEARWATER | ||||
| City | CLEARWATER |
| Zip Code | 33764 |
Please comment or provide details below to improve the information on EDENVILLE MANOR LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.