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INDIGO MANOR ASSISTED LIVING
NPI 1952720294
Assisted Living Facility in Daytona Beach, FL

Active since April 15, 2014CLIA 10D0267625 · Waiver
595 N WILLIAMSON BLVD, DAYTONA BEACH, FL 32114(386) 257-4400(386) 257-4372 Get Directions Write a Review

NPPES record last updated: April 15, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Indigo Manor Assisted Living NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INDIGO MANOR ASSISTED LIVING (NPI 1952720294) is a healthcare organization registered as an assisted living facility in Daytona Beach, Florida and active in the NPI registry since April 2014. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Randolph Lee Kernon, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1952720294
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameALLIANCE FOUNDATION OF FLORIDA INC
Location Address595 N WILLIAMSON BLVDDaytona Beach, FL 32114-7185
Mailing Address595 N Williamson BlvdDaytona Beach, FL 32114-7185 · (386) 257-4400 · Fax (386) 257-4372
Phone(386) 257-4400
Fax(386) 257-4372
Organization SubpartYes
Authorized OfficialRandolph Lee KernonExecutive Director · (386) 547-4686
Enumeration DateApril 15, 2014
✔ NPI 1952720294 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in FL · AL5400
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
595 N WILLIAMSON BLVD, Daytona Beach, FL 32114
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Other Names 1

Doing Business AsIndigo Manor Assisted Living

Other Identifiers 1

OtherAL5400FL · State Of Florida Ahca

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0267625

Indigo Manor · Daytona Beach, FL
Active · expires Aug 31, 2026
CLIA Number10D0267625
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorAvrohom Brog
Laboratory Phone(904) 257-4400
Laboratory LocationIndigo Manor595 Williamson Blvd, Daytona Beach, FL 32114
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BEDROCK HCS AT DAYTONA FL LLC
Skilled Nursing Facility
595 N WILLIAMSON BLVD
DAYTONA BEACH, FL 32114
Volusia County (732) 328-7499
DENIS MAROIS SLP
Speech-Language Pathologist
595 N WILLIAMSON BLVD
DAYTONA BEACH, FL 32114
Volusia County (386) 257-4400
RONALD MARTEENY
Physical Therapy Assistant
595 N WILLIAMSON BLVD
DAYTONA BEACH, FL 32114
Volusia County (386) 257-4400
ALLIANCE FOUNDATION OF FLORIDA INC
Skilled Nursing Facility
595 N WILLIAMSON BLVD
DAYTONA BEACH, FL 32114
Volusia County (386) 257-4400
KIMBERLY GESSNER-BUCKINGHAM
Physical Therapist
595 N WILLIAMSON BLVD
DAYTONA BEACH, FL 32114
Volusia County (386) 257-4400
MS. SHANNON DRE CHISHOLM PA-C
Physician Assistant
595 N WILLIAMSON BLVD
DAYTONA BEACH, FL 32114
Volusia County (872) 231-3162
HEALTH CARE SERVICES POOL, LLC
Registered Nurse
595 N WILLIAMSON BLVD
DAYTONA BEACH, FL 32114
Volusia County (386) 257-4400
DIRECT THERAPY SERVICES LLC
Physical Therapist
595 N WILLIAMSON BLVD
DAYTONA BEACH, FL 32114
Volusia County (386) 257-4400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alliance Foundation Of Florida Inc's NPI number?

The NPI number for Alliance Foundation Of Florida Inc is 1952720294. It was assigned to this organization in the NPPES registry on April 15, 2014. The provider is doing business as Indigo Manor Assisted Living.

Where is Alliance Foundation Of Florida Inc located?

Alliance Foundation Of Florida Inc is located at 595 N Williamson Blvd, Daytona Beach, FL 32114. The listed phone number is (386) 257-4400.

What is Alliance Foundation Of Florida Inc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Alliance Foundation Of Florida Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0267625) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Alliance Foundation Of Florida Inc was last updated on April 15, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.