Organization
MINERVA MANOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLYANN SUE (MANAGING MEMBER)
(347) 258-0686
Entity
Organization
Contact information
Practice address
605 FORREST RD, WARSAW, NC 28398-2209
(516) 851-5471
Mailing address
10040 199TH ST, HOLLIS, NY 11423-3327
(347) 258-0686
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
11/23/2022
Last updated
11/23/2022
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