Naomi Janace Armistead
Custodial Care Facility, Adult Care Home in Starke, FL. Organization (NPI-2).
NPI number1366782575
StatusActive
Last updated in NPPESFeb 25, 2013
Details
- NPI
- 1366782575
- Entity type
- Organization (NPI-2)
- Legal business name
- Naomi Janace Armistead
- Organization subpart
- No
- Enumeration date
- Feb 25, 2013
- Last updated
- Feb 25, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 311ZA0620X | Custodial Care Facility, Adult Care Home | 6906444 | FL | Yes |
Other names
- Pine Forest Manor, LLC (Doing Business As)
Practice location
2876 Se 109th StStarke, FL 32091-7461
Phone 352-468-2435 · Fax 352-468-2435
Mailing address
2876 Se 109th StStarke, FL 32091-7461
Phone 352-468-2435 · Fax 352-468-2435
Authorized official
Naomi Janace Armistead
Owner
3524682435
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