Organization
LAKE WALES HEALTHCARE LLC
Active
Other names
Grace Healthcare of Lake Wales
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICE MARIE CLARK DANKS CPA (VP OF FINANCE)
(423) 308-1845
Entity
Organization
Contact information
Practice address
730 N SCENIC HWY, LAKE WALES, FL 33853-3208
(863) 676-1512
Mailing address
730 N SCENIC HWY, LAKE WALES, FL 33853-3208
(863) 676-1512
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF12760961
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031934100
—
FL
Enumeration date
02/01/2011
Last updated
02/01/2011
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