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Organization

INDIAN SHORE MANOR, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MERITA MASON (ADMINISTRATOR)
(718) 344-3828
Entity
Organization

Contact information

Practice address
1611 INDIAN SHORE DR, CLERMONT, FL 34711-2981
(352) 404-8571
Mailing address
1611 INDIAN SHORE DR, CLERMONT, FL 34711-2981

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12464
FL

Other

Enumeration date
07/29/2014
Last updated
07/29/2014
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