NPI 1568089050

Florida Homestyle Manor, LLC

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Clermont, FL

Practice location

Address: 481 Dagama Dr, Clermont, FL 34715-8037
Phone: (205) 541-9580
Mailing address: 1105 Sadie Ridge Rd, Clermont, FL 34715-0069

Authorised official

Name: Anthony C Grove
Title: Chief Executive Officer
Phone: (205) 541-9580

Registered specialties (3)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Florida →

Developmentally Disabled Services Day Training Agency

Agencies Taxonomy 251C00000X

Other Day Training, Developmentally Disabled Services providers in Florida →

Intellectual and/or Developmental Disabilities Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320600000X

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Florida →

Registry record

NPI: 1568089050
Entity type: Organization
NPI issued: 30 Jun 2020
Record last updated: 22 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.