| NPI | 1164180428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE MARSHA PETITHOMME Registered Nurse 407-885-9292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2021-12-03 |
| Last Update Date | 2021-12-03 |