| NPI | 1154742922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELETT MARIE JOHNSON Administrator 813-857-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL 11570) |
| Enumeration Date | 2013-12-22 |
| Last Update Date | 2013-12-22 |