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Organization
ST. THOMAS MANOR, INC.
Active
Organization
ST. THOMAS MANOR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATHEW JACOB (PRESIDENT/OWNER)
(954) 583-3321
Entity
Organization
Contact information
Practice address
1110 SW 40TH AVE, PLANTATION, FL 33317-4527
(954) 583-3321
Mailing address
1110 SW 40TH AVE, PLANTATION, FL 33317-4527
(954) 583-3321
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL1063
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140824100
—
FL
Enumeration date
10/09/2008
Last updated
10/09/2008
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