| NPI | 1255734224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOTLYN SALOME COLEMAN Owner 321-303-4907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness (Licence: FL AL10701) |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2014-10-03 |