| NPI | 1114529047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED ABDELLI Administrator 850-960-5045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2020-11-16 |