JJ Manor Assisted Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

JJ MANOR ASSISTED LIVING, LLC

Practice address

2637 SW Fair Isle Rd
Port Saint Lucie, FL 34987-2093

Phone

(772) 446-2040

NPI assigned

Jun 17, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shannon Margaret EdwardsNPI 1306689468

Title

Administrator

Phone

(772) 446-2040

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shannon Margaret Edwards

  • Assisted Living Facility
  • Port Saint Lucie, FL
  • NPI 1306689468
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1013750991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2637 SW FAIR ISLE RD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872093",
            "telephone_number": "772-446-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2637 SW FAIR ISLE RD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872093",
            "telephone_number": "772-446-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JJ MANOR ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "MARGARET",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "772-446-2040"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Keanu Jeter
• Micaela Sacchi Jeziorski
• Maidis Jimenez Santos
• Diann M Jimenez, MS
• Ravi Jitta, D.C
• JN Louis LLC
• Ricardo Joassaint
• John R Istad PA
• Anthony John
• Chontel A Johnson McCallum, LMHC

• Assisted Living Facility in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.