| NPI | 1154624310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL E MACIAS Sole Mbr/Owner 850-725-1975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: FL PY8131) |
| Additional Taxonomies | 251J00000X Nursing Care (Licence: FL PY8131) |
| 251S00000X (Licence: FL PY8131) | |
| 314000000X Skilled Nursing Facility (Licence: FL PY8131) | |
| Enumeration Date | 2010-12-09 |
| Last Update Date | 2010-12-09 |