Southern Parks INC

NPI #1558667279 in Wauchula, Florida

Provider Information

NPI Number: 1558667279
Entity Type: Organization
Organization Name: Southern Parks INC
Primary Specialty: Assisted Living Facility - Assisted Living, Mental Illness
Enumeration Date: Jan 27, 2011
Last Updated: Feb 16, 2011

Practice Location

Address: 157 WILL DUKES RD
City: Wauchula
State: Florida
ZIP Code: 33873-9308
Phone: (863) 773-9557

Authorized Official

Name: MR. SANNY PRADO PANINGBATAN
Title: ADMINISTRATOR
Phone: (863) 773-9557

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assisted Living Facility - Assisted Living, Mental Illness — Assisted Living, Mental Illness	3104A0625X	Primary

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