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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