| NPI | 1144054545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BLACK Administrator 813-524-6736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2024-08-28 |
| Last Update Date | 2024-08-28 |