| NPI | 1164862967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD JEROME PORTER Director 352-258-4015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2013-06-26 |