Organization · Type 2 NPI
Country Manor Assisted Living & Retirement Home, LLC
Assisted Living Facility (Mental Illness) · Port Orange, FL
Practice location
1152 Old Hammock Rd
Port Orange, FL 32129-5016
Fax (386) 265-5937
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Assisted Living Facility (Mental Illness) Primary | 3104A0625X | 12025 (FL) |
Assisted Living Facility (Mental Illness): 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.
About NPI 1104247717
Country Manor Assisted Living & Retirement Home, LLC's National Provider Identifier is 1104247717, issued on Dec 27, 2013. The primary taxonomy on file is Assisted Living Facility (Mental Illness) (3104A0625X), and the practice location is in Port Orange, FL. The record was last updated on Dec 27, 2013.