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Organization
THE MANOR AT LAKE JACKSON MEMORY CARE
Active
Organization
THE MANOR AT LAKE JACKSON MEMORY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOUIS FORD GARRARD V (OWNER)
(863) 226-0358
Entity
Organization
Contact information
Practice address
2301 US HIGHWAY 27 S, SEBRING, FL 33870-4941
(863) 471-0772
(863) 471-0776
Mailing address
505 ARIANA AVE, AUBURNDALE, FL 33823-4139
(863) 226-0358
(863) 510-5952
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110938100
—
FL
Enumeration date
11/07/2014
Last updated
02/16/2022
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