| NPI | 1194979773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AGELET ST-HUBERT Owner/Provider 904-554-6051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906276) |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2012-04-03 |