NPI | 1164018214 |
---|---|
Entity Type | Organization |
Authorized Contact | LATASHA D GILYARD Alf Administrator 904-501-8991 |
Organization Subpart ? | No |
Primary Taxonomy | 310400000X Assisted Living Facility |
Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
Enumeration Date | 2020-12-14 |
Last Update Date | 2020-12-14 |