| NPI | 1104240209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE THERESA BOLANDER Administrator 727-347-2979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL 7642) |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2014-02-10 |