Organization
GRACE MANOR SUITES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SAVITRI JOHNSON (ADMINISTRATIVE ASSISTANT)
(863) 226-0358
Entity
Organization
Contact information
Practice address
4620 N SOCRUM LOOP ROAD, LAKELAND, FL 33809
(863) 577-0977
(863) 577-0984
Mailing address
PO BOX 2480, LAKELAND, FL 33806-2480
(863) 937-9114
(863) 510-5952
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
11995
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112829400
—
FL
Enumeration date
04/16/2014
Last updated
04/24/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up