Organization
TOTAL CARE MANOR, INC
Active
Other names
Horizon ALF
Organization subpart
No
Provider details
NPI number
Authorized official
JASON KISSOONLAL (PRESIDENT)
(954) 523-1543
Entity
Organization
Contact information
Practice address
1490 NW 21 STREET, FORT LAUDERDALE, FL 33311
(954) 523-1543
(954) 527-0505
Mailing address
1490 NW 21 STREET, FORT LAUDERDALE, FL 33311
(954) 523-1543
(954) 527-0505
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL8595
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141923400
—
FL
Enumeration date
10/16/2008
Last updated
08/26/2020
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