| NPI | 1134550718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANEE PHOUTHAVONG Owner 727-754-5309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL12322) |
| Enumeration Date | 2013-12-06 |
| Last Update Date | 2013-12-06 |