GRACE MANOR SUITES (NPI# 1750700860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750700860 |
| Entity Type | Organization |
| Organization Name | GRACE MANOR SUITES |
| Practice Address |
4620 N Socrum Loop Road Lakeland FL 33809 |
| Mailing Address |
Po Box 2480 Lakeland FL 33806-2480 |
| Practice Telephone | 8635770977 |
| Practice Fax Number | 8635770984 |
| Mailing Telephone | 8639379114 |
| Mailing Fax Number | 8635105952 |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2014-11-20 |
| Authorized Official Name | MS. JENNIFER LYNN GARRARD (ASST. ADMINISTRATOR) |
| Authorized Official Telephone | 8632260358 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 11995 | FL | Nursing & Custodial Care Facilities |
| Street Address |
4620 N SOCRUM LOOP ROAD |
| City | LAKELAND |
| State | FL |
| Zip Code | 33809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861018178 | John C Gallik | Military Health Care Provider | 3176 Corporal Johnson Road, Jbsa Fort Sam Houston, TX 33809 | 2020-06-23 |
| 1376189209 | Julie Independence Tomchak | Nurse's Aide | 7805 Us Highway Lot 29 # 98 N, Lakeland, FL 33809 | 2019-11-26 |
| 1912465923 | Lakeland Oaks Nh LLC | Skilled Nursing Facility | 855 Carpenters Way, Lakeland, FL 33809 | 2019-03-08 |
| 1235528753 | Christia Mccann | Physician Assistant | 4120 Us Hwy. 98 N., One Lakeland Square, Lakeland, FL 33809 | 2015-01-21 |
| 1548679616 | Ashley Frances Hamarowicz | Physical Therapist | 771 Carpenters Way, Lakeland, FL 33809 | 2014-08-04 |
| 1164769980 | Christopher Fisher | Hearing Instrument Specialist | 3800 North Rd 98, Ste 500, Lakeland, FL 33809 | 2013-01-14 |
| 1023374063 | Eagle Lake Pharmacy Inc | Pharmacy | 5245 A U S Hwy 98 N, Suite A, Lakeland, FL 33809 | 2012-04-04 |
| 1851669675 | Reginald Keith Jenkins | Pharmacist | 1043 Walt Williams Road, Lakeland, FL 33809 | 2011-12-07 |
| 1578859633 | Jill Margaret Waldrop | Pharmacist | 6600 N. Socrum Loop, Lakeland, FL 33809 | 2011-06-27 |
| 1154598555 | Mission Health & Massage Inc. | Massage Therapist | 930 Marcum Road Suite 5, Lakeland, FL 33809 | 2008-05-14 |
| Find all providers in zip 33809 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831798289 | Siloam Health Care Services | Assisted Living Facility | 1205 Neville Ave, Lakeland, FL 33805-4144 | 2020-10-17 |
| 1841709847 | Senior Living Properties Iv, LLC | Assisted Living Facility | 605 Carpenters Way, Lakeland, FL 33809-3919 | 2017-09-22 |
| 1972975605 | The Manor At Lake Morton | Assisted Living Facility | 522 E Lime St, Lakeland, FL 33801-5313 | 2015-10-21 |
| 1780019992 | Florida Living Options Inc | Assisted Living Facility | 6150 Lakeland Highlands Rd, Lakeland, FL 33813-3850 | 2013-09-06 |
| 1922396431 | Kindhearted Assisted Living Facility, Inc. | Assisted Living Facility | 2815 Cleveland Heights Blvd, Lakeland, FL 33803-4107 | 2011-07-18 |
| 1477858520 | Lwrc Inc | Assisted Living Facility | 315 W Peachtree St, Lakeland, FL 33815-1531 | 2011-01-21 |
| 1013167691 | Lake Morton Plaza, LLC | Assisted Living Facility | 400 S Florida Ave, Lakeland, FL 33801-5254 | 2008-09-19 |
| 1740449263 | Andrada Guerzon #1 Corp | Assisted Living Facility | 815 W Daughtery Rd, Lakeland, FL 33809-3121 | 2008-06-09 |
| 1992979405 | Sedona Garden Assisted Living & Memory Care | Assisted Living Facility | 610 E Lime St, Lakeland, FL 33801-5444 | 2008-04-15 |
| 1548443666 | Perpetual Care & Senior Living Services Inc. | Assisted Living Facility | 747 Bon Air St, Lakeland, FL 33805-4631 | 2007-12-12 |
| Find all providers in LAKELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.