| NPI | 1164800819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILEDY MARTINEZ Administrator 813-880-8393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906029) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2015-05-14 |