OrganizationActive
Indian Shore Manor, LLC
NPI 1639587108 · Assisted Living Facility · Clermont, FL
Provider details
- NPI number
- 1639587108
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Merita Mason, Administrator(718) 344-3828
- License
- AL12464 (FL)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1611 Indian Shore Dr
Clermont, FL 34711-2981
Phone: (352) 404-8571
Street-level locationGet directions
Mailing address
1611 Indian Shore Dr
Clermont, FL 34711-2981
Registry dates
- Enumerated
- 2014-07-29
- Last updated
- 2014-07-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.