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General NPI Number Information
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NPI Number | 1225135353
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Entity Type | Organization
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Legal Business Name | SF III TLF, LLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/02/2020
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Provider Practice Location Address
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Address Line | 1962 VANDOLAH ROAD
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City | WAUCHULA
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State | FL
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Zip | 33873
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Country | US
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Telephone | 863-773-2857
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Fax | 863-773-2041
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Provider Business Mailing Address
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Address Line | PO BOX 1348
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City | WAUCHULA
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State | FL
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Zip | 33873-1348
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Country | US
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Telephone | 863-773-2857
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Fax | 863-773-2041
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Authorized Official
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Title or Position | COLLECTIONS MANAGER
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Name | MS. ELIZABETH CHOQUETTE
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Credential |
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Telephone | 863-767-4484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number | TLF70090971
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | TLF7006096
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | TLF7006096
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 100045445
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number | TLF7006096
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License Number State | FL
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