| NPI | 1174965040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IGOR MEINICHUK Alf Owner 727-498-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: FL 11367) |
| Enumeration Date | 2013-07-21 |
| Last Update Date | 2022-03-26 |