| NPI | 1184059750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESUSA H. KEPLER Owner/Administrator 386-428-3018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL11072) |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2013-09-13 |