| NPI | 1043557465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENE LOPEZ-MARTINEZ Administrator 813-407-6888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL 310400000x) |
| Enumeration Date | 2013-01-04 |
| Last Update Date | 2013-01-04 |