Stone Ledge Manor

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL11289 Issued in FL

Legal business name

STONE LEDGE MANOR

Practice address

12006 McIntosh Rd
Thonotosassa, FL 33592-3813

Phone

(813) 986-7900

NPI assigned

Dec 1, 2008

Organization subpart

No

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

Authorized official

Name

Malcolm Harriman

Title

Executive Director

Phone

(813) 986-7900

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228089600000",
    "number": "1023263274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12006 MCINTOSH RD",
            "city": "THONOTOSASSA",
            "state": "FL",
            "postal_code": "335923813",
            "telephone_number": "813-986-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12006 MCINTOSH RD",
            "city": "THONOTOSASSA",
            "state": "FL",
            "postal_code": "335923813",
            "telephone_number": "813-986-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE LEDGE MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2008-12-01",
        "status": "A",
        "authorized_official_last_name": "HARRIMAN",
        "authorized_official_first_name": "MALCOLM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "813-986-7900"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Thonotosassa, FL
• Providers in Thonotosassa, 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 Dec 1, 2008; 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.