| NPI | 1063834729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENSLY TERRELL JOHNSON Director 904-766-7885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2014-01-16 |