Provider Demographics
NPI:1285078758
Name:CARLTON MANOR, INC.
Entity type:Organization
Organization Name:CARLTON MANOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TARGETED CASE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMANCIK
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:727-343-3662
Mailing Address - Street 1:45 WESTWOOD TER N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-8325
Mailing Address - Country:US
Mailing Address - Phone:727-343-3662
Mailing Address - Fax:727-347-1649
Practice Address - Street 1:45 WESTWOOD TER N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-8325
Practice Address - Country:US
Practice Address - Phone:727-343-3662
Practice Address - Fax:727-347-1649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management