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General NPI Number Information
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NPI Number | 1609869825
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Entity Type | Organization
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Legal Business Name | FLORIDA PRESBYTERIAN HOMES, INC.
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 909 S LAKESIDE AVE
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City | LAKELAND
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State | FL
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Zip | 33803-1031
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Country | US
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Telephone | 863-688-5521
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Fax | 863-687-4088
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Provider Business Mailing Address
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Address Line | 16 LAKE HUNTER DR
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City | LAKELAND
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State | FL
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Zip | 33803-1297
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Country | US
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Telephone | 863-688-5521
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Fax | 863-687-4088
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Authorized Official
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Title or Position | CEO
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Name | HENRY THOMAS KEITH
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Credential |
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Telephone | 407-839-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | SNF130470964
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License Number State | FL
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