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Organization

STONE LEDGE MANOR

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MALCOLM HARRIMAN (EXECUTIVE DIRECTOR)
(813) 986-7900
Entity
Organization

Contact information

Practice address
12006 MCINTOSH RD, THONOTOSASSA, FL 33592-3813
(813) 986-7900
Mailing address
12006 MCINTOSH RD, THONOTOSASSA, FL 33592-3813
(813) 986-7900

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11289
FL

Other

Enumeration date
12/01/2008
Last updated
12/01/2008
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