| NPI | 1215235296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERTONY BORNELUS Adminstrator 850-766-5208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: GA 033013151) |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2011-03-01 |