| NPI | 1144582461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY JAQUES President, Rmi, Management Agent 386-774-8878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL11742) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2012-06-12 |