FLORIDA HOMESTYLE MANOR, LLC (NPI# 1568089050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568089050 |
| Entity Type | Organization |
| Organization Name | FLORIDA HOMESTYLE MANOR, LLC |
| Practice Address |
481 Dagama Dr Clermont FL 34715-8037 |
| Mailing Address |
1105 Sadie Ridge Rd Clermont FL 34715-0069 |
| Practice Telephone | 2055419580 |
| Mailing Telephone | 2055419580 |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2020-07-06 |
| Authorized Official Name | ANTHONY C GROVE (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2055419580 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 13351204Z | 05 |
| Street Address |
481 DAGAMA DR |
| City | CLERMONT |
| State | FL |
| Zip Code | 34715-8037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275147811 | Sharon George | Physical Therapy Assistant | 301 Us-27 N, Minneola, FL 34715 | 2020-09-01 |
| 1689133290 | Mohawk Surgery Center LLC | Clinic/Center | 201 Mohawk Rd, Minneola, FL 34715 | 2019-03-14 |
| 1518489970 | Blake Desenti | Student in an Organized Health Care Education/Training Program | 819 Park Trail Drive, Minneola, FL 34715 | 2017-07-07 |
| 1265855217 | John Geron Rogers | Counselor | 506 S. Hwy 27, Ste N, Minneola, FL 34715 | 2014-01-28 |
| 1609217132 | Linda Jean Thomas | Speech-Language Pathologist | 20444 Sugarloaf Mountain Road, Clermont, FL 34715 | 2013-07-12 |
| 1164783833 | Richard Doiron | Physical Therapy Assistant | 236 Mohawk Road, Clermont, FL 34715 | 2012-05-30 |
| 1194023283 | Simon James Mitchell | Speech-Language Pathologist | 200 C S Hwy 27, Clermont, FL 34715 | 2011-03-14 |
| 1134438864 | Minneola Chiropractic LLC | Chiropractor | 600 N Us Highway 27, Suite 2, Minneola, FL 34715 | 2010-09-29 |
| 1013238740 | Kingdom Building Services LLC | Community/Behavioral Health | 833 Willow Run St, Suite A, Minneola, FL 34715 | 2010-06-16 |
| 1033353313 | Orvil Luis Ayala | Anesthesiology | 240 Mohawk Rd, Clermont, FL 34715 | 2009-04-30 |
| Find all providers in zip 34715 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770101859 | Humble Hearts of Central Florida LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11509 Pineloch Loop, Clermont, FL 34711-6459 | 2020-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568294 | Open Skyes Family Care Home, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5600 Sw 36th St, West Park, FL 33023-6106 | 2020-11-08 |
| 1124628565 | Rachelle Homehealth Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8539 Gate Pkwy W Unit 9134, Jacksonville, FL 32216-1037 | 2020-10-26 |
| 1497368203 | Careola LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3248 Landing Vw, Tavares, FL 32778-2035 | 2020-08-31 |
| 1982218764 | The Home W/ Guiding Hands | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1256 N Florida Ave, Tarpon Springs, FL 34689-2004 | 2020-08-31 |
| 1306459359 | Joy-little Enterprise LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9148 Ridge Blvd, Jacksonville, FL 32208-1265 | 2020-08-28 |
| 1720691082 | Ohana In Home Senior Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 421 W Georgia St, Tallahassee, FL 32301-1011 | 2020-08-26 |
| 1003428467 | Pamella Omelda Odoms-brown | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 541 Shirley Dr., Apopka, FL 32712 | 2020-08-18 |
| 1831700020 | Mikerline Lyns | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10941 Winding Creek Ln, Boca Raton, FL 33428-5664 | 2020-08-12 |
| 1902416993 | Faith Care Center, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3800 Inverrary Blvd Ste 408d, Lauderhill, FL 33319-4359 | 2020-08-04 |
| 1063020188 | Kristine Kaiser Cravener | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1095 Beckman Dr, South Daytona, FL 32119-2499 | 2020-07-14 |
| Find all providers with the same taxonomy | ||||
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| 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.