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Organization
SOUTHERN PARKS INC
Active
Organization
SOUTHERN PARKS INC
Active
Other names
SOUTHERN OAKS ALF
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SANNY PRADO PANINGBATAN (ADMINISTRATOR)
(863) 773-9557
Entity
Organization
Contact information
Practice address
157 WILL DUKES RD, WAUCHULA, FL 33873-9308
(863) 773-9557
(863) 773-0764
Mailing address
157 WILL DUKES RD, WAUCHULA, FL 33873-9308
(863) 773-9557
(863) 773-0764
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL7853
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140885200
—
FL
Enumeration date
01/27/2011
Last updated
02/16/2011
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