| NPI | 1053757294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH J DESMORNES Provider 239-204-6373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906581) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2013-07-10 |