Provider Demographics
NPI:1255851168
Name:THE LEXINGTON MANOR ADULT FAMILY HOMECARE INC
Entity type:Organization
Organization Name:THE LEXINGTON MANOR ADULT FAMILY HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONAS
Authorized Official - Middle Name:
Authorized Official - Last Name:AUGUSTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-422-7059
Mailing Address - Street 1:1337 PINETTA CIR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6015
Mailing Address - Country:US
Mailing Address - Phone:561-422-7059
Mailing Address - Fax:561-508-4797
Practice Address - Street 1:1337 PINETTA CIR
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414
Practice Address - Country:US
Practice Address - Phone:561-422-7059
Practice Address - Fax:561-508-4797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
310400000X
FLAL13025310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility