# MINERVA MANOR LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023727500
- **Authorized official:** HOLLYANN SUE (MANAGING MEMBER)
- **Authorized official phone:** (347) 258-0686

## Contact information

- **Practice address:** 605 FORREST RD, WARSAW, NC 28398-2209
- **Practice address phone:** (516) 851-5471
- **Mailing address:** 10040 199TH ST, HOLLIS, NY 11423-3327
- **Mailing address phone:** (347) 258-0686

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 11/23/2022
- **Last updated:** 11/23/2022