| 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 |