Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Country Manor Assisted Living & Retirement Home, LLC

Assisted Living Facility (Mental Illness) in Port Orange, FL · enumerated 2013 · authorized official Arnulfo Simondac, Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1104247717

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Registry record

Entity type Organization (Type 2)

Legal business name Country Manor Assisted Living & Retirement Home, LLC

Practice address 1152 Old Hammock Rd, Port Orange, FL, 32129

Phone (386) 265-5935

Fax (386) 265-5937

Enumeration date Dec 27, 2013

Last updated in NPPES Dec 27, 2013

Taxonomy & classification

3104A0625X Assisted Living Facility (Mental Illness) Nursing & Custodial Care Facilities · License 12025 (FL) Primary

Authorized official

Name Arnulfo Simondac

Title Administrator

Phone (386) 589-6252

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Who is the authorized official for Country Manor Assisted Living & Retirement Home, LLC?

NPPES lists Arnulfo Simondac (Administrator) as the authorized official for this organization.

What is the NPI number for Country Manor Assisted Living & Retirement Home, LLC?

The NPI for Country Manor Assisted Living & Retirement Home, LLC is 1104247717, a Type 2 (organization) record in the CMS NPPES registry.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2013-12-27.