| NPI | 1043612930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED ABDELLI Administrator 850-960-5045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: FL 60081009) |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2014-09-22 |