| NPI | 1053786806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORYLYN T MANIAGO Administrator 813-689-3707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL12747) |
| Enumeration Date | 2015-12-04 |
| Last Update Date | 2015-12-11 |