Maranatha Manor Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10086 Issued in FL

Legal business name

MARANATHA MANOR INC.

Practice address

54 Maranatha Blvd
Sebring, FL 33870-6818

Phone

(863) 471-2766

Fax

(863) 471-2788

NPI assigned

Aug 10, 2007

Last updated

Aug 10, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Amy Jo Van Kleeck

Title

Administrator

Phone

(863) 471-2766

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186704000000",
    "number": "1700078110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 MARANATHA BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338706818",
            "telephone_number": "863-471-2766",
            "fax_number": "863-471-2788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 MARANATHA BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338706818",
            "telephone_number": "863-471-2766",
            "fax_number": "863-471-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARANATHA MANOR INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-10",
        "last_updated": "2007-08-10",
        "status": "A",
        "authorized_official_last_name": "VAN KLEECK",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "863-471-2766",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Sebring, FL
• Providers in Sebring, 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 Aug 10, 2007; 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.