VICTORIAN MANOR, INC. (NPI# 1972121192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972121192 |
| Entity Type | Organization |
| Organization Name | VICTORIAN MANOR, INC. |
| Practice Address |
11150 Sw 42nd Ct Davie FL 33328-2140 |
| Mailing Address |
15140 Sw 38th St Davie FL 33331-2755 |
| Practice Telephone | 9542364300 |
| Mailing Telephone | 9548163203 |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2020-07-14 |
| Authorized Official Name | NOEMI RODRIGUEZ (ONWNER) |
| Authorized Official Telephone | 9542364300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Victorian Manor, Inc. | Former Legal Business Name - Organization |
| Street Address |
11150 SW 42ND CT |
| City | DAVIE |
| State | FL |
| Zip Code | 33328-2140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306496708 | Venise Jacqueslouis | Behavior Technician | 8001 We 36th St, Suite 9, Davie, FL 33328 | 2019-09-17 |
| 1134780539 | 1st Nursing Care Services | Registered Nurse | 10335 Sw 50th Ct, Cooper City, FL 33328 | 2019-06-26 |
| 1023572245 | Rezan Tewolde | Pharmacist | 37772 Churchill Downs Drive, Davie, FL 33328 | 2019-01-23 |
| 1497237820 | Yasmeen Dahsheh | Behavior Technician | 8001 Sw 36th Street Suite #9, Davie, FL 33328 | 2018-09-01 |
| 1831686948 | Kristal Arias | Behavior Technician | 8001 Sw 36th Street, Suite #9, Davie, FL 33328 | 2018-04-16 |
| 1952810384 | April R Hardy | Behavior Technician | 8001 Sw 36 Street Suite 9, Davie, FL 33328 | 2017-09-28 |
| 1609391556 | Courtney M Talbert | Behavior Technician | 8001 Sw 36 St, Suite 9, Davie, FL 33328 | 2017-08-11 |
| 1639619349 | Remya Mathew | General Acute Care Hospital | 10030 Grove Ln, Cooper City, FL 33328 | 2017-02-28 |
| 1184161945 | Elizabeth Stabinski | Marriage & Family Therapist | 4900 South University Drive, Suite 200d, Davie, FL 33328 | 2017-01-31 |
| 1285097659 | Pandolfi Counseling Associates, Inc. | Social Worker | 5291 Sw 89th Ave, Cooper City, FL 33328 | 2016-04-01 |
| Find all providers in zip 33328 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396461 | Hillendale Cares LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 27357 Frampton Ave, Brooksville, FL 34602-7306 | 2020-11-02 |
| 1699375485 | Violange Joseph | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3310 Sw Frankford St, Port St Lucie, FL 34953-4937 | 2020-10-29 |
| 1407468986 | Winchester Oaks Corporation | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 871 Winchester St, Daytona Beach, FL 32114-1977 | 2020-08-17 |
| 1609486844 | Aclaris Care Home, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 7711 N Rome Ave, Tampa, FL 33604-4615 | 2020-08-03 |
| 1386253987 | Rosa Estela Companioni | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6704 Commodore Way, Tampa, FL 33615-5810 | 2020-07-29 |
| 1881233716 | Elizabeth Stapleton | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4628 25th St Sw, Lehigh Acres, FL 33973-6161 | 2019-12-23 |
| 1689217887 | Angelchild Homecare Corp Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1641 Sunset Point Rd, Clearwater, FL 33755-1657 | 2019-10-21 |
| 1659927325 | Coby Cares Corporation | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1754 Barnstable Rd, Wellington, FL 33414-6143 | 2019-08-17 |
| 1518520725 | Freshen Schammua Docile | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9097 Sw 4th St, Boca Raton, FL 33433-4607 | 2019-04-15 |
| 1841752888 | Developing New Horizons | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1500 Nw 89th Ct Ste 111b, Doral, FL 33172-2640 | 2019-04-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.