| NPI | 1043642606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALDENE FORDE Administrator 727-896-4515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: FL AL10857) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2013-08-06 |