| NPI | 1275163412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA VENORD DORVAL Owner 321-947-6372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2020-01-15 |
| Last Update Date | 2020-01-15 |