COUNTRY MANOR ASSISTED LIVING & RETIREMENT HOME, LLC
NPI 1104247717
Assisted Living Facility - Assisted Living, Mental Illness in Port Orange, FL
NPI Status: Active since December 27, 2013
Contact Information
1152 OLD HAMMOCK RD
PORT ORANGE, FL
ZIP 32129
Phone: (386) 265-5935
Fax: (386) 265-5937
- Organization
- Assisted Living Facility
- Assisted Living, Mental Illness
About COUNTRY MANOR ASSISTED LIVING & RETIREMENT HOME, LLC
This page provides the complete NPI Profile along with additional information for Country Manor Assisted Living & Retirement Home, Llc, a provider established in Port Orange, Florida operating as a Assisted Living Facility, focusing in assisted living, mental illness . The healthcare provider is registered in the NPI registry with number 1104247717 assigned on December 2013. The practitioner's primary taxonomy code is 3104A0625X with license number 12025 (FL). The provider is registered as an organization and their NPI record was last updated 12 years ago. The authorized official of this NPI record is Mr. Arnulfo Salgado Simondac (Administrator)
- NPI
- 1104247717
- Provider Name
- COUNTRY MANOR ASSISTED LIVING & RETIREMENT HOME, LLC
- Entity Type
- Organization
- Location Address
- 1152 OLD HAMMOCK RD PORT ORANGE, FL 32129
- Location Phone
- (386) 265-5935
- Location Fax
- (386) 265-5937
- Mailing Address
- 1152 OLD HAMMOCK RD PORT ORANGE, FL 32129
- Mailing Phone
- (386) 265-5935
- Mailing Fax
- (386) 265-5937
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-27-2013
- Last Update Date
- 12-27-2013
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Assisted Living Facility Assisted Living, Mental Illness
- Taxonomy Code
- 3104A0625X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 12025
- License State
- FL
- Taxonomy Description
- A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1104247717, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 53 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104247717, enumerated as an "organization" on December 27, 2013.
The provider is located at 1152 OLD HAMMOCK RD PORT ORANGE, FL 32129 and the phone number is (386) 265-5935.
Assisted Living Facility with taxonomy code 3104A0625X and a focus in Assisted Living, Mental Illness.
