| NPI | 1083125132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRENIA BACALLAO RUIZ President 813-562-6135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL 13170) |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2019-03-06 |