| NPI | 1245643915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDULLAH SHAH Owner 904-764-2581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: FL AL5846) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2014-06-10 |