| NPI | 1073956827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILOU R OCAMPO Asst.Administrator 386-490-4940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL# 11175) |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2013-04-11 |