| NPI | 1053779637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA P WADDELL President 727-303-4129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 000000) |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2016-02-10 |