| NPI | 1104318435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA JEAN ROBERSON Administrator 813-786-9645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL 13158) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2018-06-01 |