Organization
CARLTON SHORES NH LLC
Active
Other names
Carlton Shores Health and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM P MANDO (CFO)
(813) 635-9500
Entity
Organization
Contact information
Practice address
1350 S NOVA RD, DAYTONA BEACH, FL 32114-5812
(386) 258-5544
(386) 255-5623
Mailing address
1350 S NOVA RD, DAYTONA BEACH, FL 32114-5812
(386) 258-5544
(386) 255-5623
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
6110
FL
314000000X
Skilled Nursing Facility
Primary
002213800
FL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002213800
—
FL
Enumeration date
02/22/2010
Last updated
06/20/2011
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