Enon Country Manor Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL 5153 Issued in FL

Legal business name

ENON COUNTRY MANOR INC

Practice address

7701 Enon School Rd
Walnut Hill, FL 32568-1531

Phone

(850) 327-4459

NPI assigned

Aug 20, 2010

Organization subpart

No

Name

Mr. Al Gregory

Title

Owner

Phone

(850) 327-4459

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 20, 2010.

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282262400000",
    "number": "1982910568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 ENON SCHOOL RD",
            "city": "WALNUT HILL",
            "state": "FL",
            "postal_code": "325681531",
            "telephone_number": "850-327-4459",
            "fax_number": "850-327-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 ENON SCHOOL RD",
            "city": "WALNUT HILL",
            "state": "FL",
            "postal_code": "325681531",
            "telephone_number": "850-327-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENON COUNTRY MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-20",
        "last_updated": "2010-08-20",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "AL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-327-4459",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL 5153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AL5153",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Enon Country Manor Alf LLC
• Elizabeth Anne Sanders
• Elizabeth Ashley Wright

• All providers in Walnut Hill, FL
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; 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.