| NPI | 1164115192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA LYMONOVA Administrator 727-601-3916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2023-05-26 |
| Last Update Date | 2023-05-26 |