| NPI | 1164786562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACI FARINA Regional Controller 941-497-1117 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL9249) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2012-06-29 |