| NPI | 1053560680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID SEBASTIAN WEBBE Administrator 904-476-5893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL11394) |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: FL AL11394) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2008-09-18 |