Organization
WELLINGTON MANOR, LLC
Active
Other names
Louis Garrard - Mainstay Senior Living
Organization subpart
No
Provider details
NPI number
Authorized official
JANIS K STOVALL DO (DIRECTOR OF OPERATIONS)
(386) 478-6759
Entity
Organization
Contact information
Practice address
375 HENDRICK DRIVE, NEWPORT, TN 37821-5344
(863) 226-0358
Mailing address
59 LAKE MORTON DR, LAKELAND, FL 33801-5344
(863) 226-0358
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
03/15/2019
Last updated
06/11/2019
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