| NPI | 1083037329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA ALTHEA RICHARDS Owner 904-379-0354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906605) |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2014-01-22 |