Organization
GRACE MANOR AT LAKE MORTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SAVITRI JOHNSON (ASST. ADMINISTRATOR)
(863) 226-0358
Entity
Organization
Contact information
Practice address
610 E LIME STREET, LAKELAND, FL 33801
(863) 937-9114
(863) 937-9117
Mailing address
505 ARIANA AVE, AUBURNDALE, FL 33823-4139
(863) 226-0358
(863) 875-9489
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
—
—
Other
Enumeration date
06/07/2013
Last updated
02/16/2022
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