| NPI | 1134563562 |
|---|---|
| Other Name | ASSISTED LIVING FACILILTY |
| Entity Type | Organization |
| Authorized Contact | MONICA W. BROWN Administrator 772-340-4671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: FL 12437) |
| 310400000X Assisted Living Facility (Licence: FL 12692) | |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2018-12-14 |