| NPI | 1023734167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L GONZALEZ GONZALEZ President 786-414-7602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2022-10-19 |