| NPI | 1265104855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NETASHA KING Owner 904-371-3211 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 251J00000X Nursing Care |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 313M00000X Nursing Facility/Intermediate Care Facility | |
| 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2021-10-01 |