| Organization Name: | SOUTHERN PARKS INC |
| NPI Number: | 1558667279 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SANNY PRADO PANINGBATAN (ADMINISTRATOR) |
| Mailing Address: | 157 Will Dukes Rd Wauchula |
| State: | FL US |
| Postal Code: | 338739308 |
| Phone Number: | 8637739557 |
| Fax Number: | 8637730764 |
| NPI Enumeration Date: | 01/27/2011 |
| NPI Last Update Date: | 02/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3104A0625X |
| License Number: | AL7853 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Assisted Living Facility |
| Taxonomy Specialization: | Assisted Living, Mental Illness |
| Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |