| Entity Name: | SOUTHERN PARKS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 17 Nov 1999 (25 years ago) |
| Document Number: | P99000101588 |
| FEI/EIN Number | 650967334 |
| Address: | 157 WILL DUKE ROAD, WAUCHULA, FL, 33873 |
| Mail Address: | P. O. BOX 789, WAUCHULA, FL, 33873, US |
| ZIP code: | 33873 |
| County: | Hardee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558667279 | 2011-01-27 | 2011-02-16 | 157 WILL DUKES RD, WAUCHULA, FL, 338739308, US | 157 WILL DUKES RD, WAUCHULA, FL, 338739308, US | |||||||||||||||||||||||||
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| Phone | +1 863-773-9557 |
| Fax | 8637730764 |
Authorized person
| Name | MR. SANNY PRADO PANINGBATAN |
| Role | ADMINISTRATOR |
| Phone | 8637739557 |
Taxonomy
| Taxonomy Code | 3104A0625X - Assisted Living Facility (Mental Illness) |
| License Number | AL7853 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 140885200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DANKO SHERIDAN | Agent | 3566 TRIPOLI BLVD, PUNTA GORDA, FL, 33950 |
| Name | Role | Address |
|---|---|---|
| DANKO H. SHERIDAN | President | 3566 TRIPOLI BLVD, PUNTA GORDA, FL, 33950 |
| Name | Role | Address |
|---|---|---|
| DANKO H. SHERIDAN | Director | 3566 TRIPOLI BLVD, PUNTA GORDA, FL, 33950 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
