| NPI | 1194177097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE H COOPER Owner/Administrator 941-766-7178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL12849) |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: FL AL12849) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2016-07-05 |