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Country Manor Assisted Living & Retirement Home, Llc
Assisted Living Facility (Mental Illness) in Port Orange, Florida
NPI 1104247717

Country Manor Assisted Living & Retirement Home, Llc is an Assisted Living Facility (Mental Illness) based in Port Orange, FL and is specialized in Assisted Living, Mental Illness. Country Manor Assisted Living & Retirement Home, Llc practices in Port Orange, FL. The NPI Number for Country Manor Assisted Living & Retirement Home, Llc is 1104247717 and holds a License No. 12025 (Florida).

The current practice location address for Country Manor Assisted Living & Retirement Home, Llc is 1152 Old Hammock Rd, Port Orange, FL and can be reached out via phone at 386-265-5935 and via fax at 386-265-5937.

Location: 1152 Old Hammock Rd, Port Orange, FL, 32129-5016
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104247717
Provider Name
Country Manor Assisted Living & Retirement Home, Llc
Credential
Provider Entity Type
Organization
Address
1152 Old Hammock Rd, Port Orange, FL, 32129-5016
Phone Number
386-265-5935
Fax Number
386-265-5937
Provider Enumeration Date
12/27/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1152 Old Hammock Rd
City
Port Orange
State
Florida
Zip
32129-5016
Phone Number
386-265-5935
Fax Number
386-265-5937
person
Provider Business Mailing Address Details
Address
1152 Old Hammock Rd
City
Port Orange
State
Florida
Zip
32129-5016
Phone Number
386-265-5935
Fax Number
386-265-5937
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
Assisted Living, Mental Illness
Taxonomy
3104A0625X
License No.
12025 (Florida)
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.
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