Organization
MENORAH MANOR INC
Active
Other names
MENORAH MANOR
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA PERRYMAN CPA (CHIEF FINANCIAL OFFICER)
(727) 302-3702
Entity
Organization
Contact information
Practice address
255 59TH ST N, ST PETERSBURG, FL 33710
(727) 345-2775
(727) 344-8593
Mailing address
255 59TH ST N, ST PETERSBURG, FL 33710-8539
(727) 345-2775
(727) 344-8593
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1344096
FL
332B00000X
Durable Medical Equipment & Medical Supplies
4037350001
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020844200
—
FL
Enumeration date
05/29/2006
Last updated
06/27/2018
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