Organization
SEDGEWOOD MANOR HEALTHCARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAVITRI JOHNSON (ADMINISTRATIVE ASSISTANT)
(863) 226-0358
Entity
Organization
Contact information
Practice address
1645 RIDGE RD, HOPKINS, SC 29061-8432
(803) 776-3873
Mailing address
1833 S FLORIDA AVE, LAKELAND, FL 33803-2653
(863) 226-0358
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RC1532
—
SC
Enumeration date
12/03/2020
Last updated
11/25/2024
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