| NPI | 1194159533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE RUTH MILLER Care Giver 813-671-5810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6905097) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2014-03-10 |