| NPI | 1215368535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILAGRO LEAL Administrator 813-966-5335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL 11704) |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2013-12-12 |