Organization
ENON COUNTRY MANOR ALF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN ANDERSON (MM)
(941) 806-7007
Entity
Organization
Contact information
Practice address
7701 ENON SCHOOL RD, WALNUT HILL, FL 32568-1531
(941) 809-6147
Mailing address
PO BOX 110363, LAKEWOOD RCH, FL 34211-0005
(941) 809-6147
(941) 567-4753
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL5153
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140281100
—
FL
Enumeration date
09/17/2010
Last updated
09/17/2010
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