| NPI | 1275760217 |
|---|---|
| Doing Business As | SAND LAKE ASSISTED LIVING FACILITY |
| Entity Type | Organization |
| Authorized Contact | ALEX VALLE President 321-303-7702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL11561) |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: FL AL 11561) |
| 314000000X Skilled Nursing Facility (Licence: FL AL 11561) | |
| 315D00000X Hospice, Inpatient (Licence: FL AL 11561) | |
| 347C00000X Private Vehicle | |
| 385H00000X Respite Care (Licence: FL AL 11561) | |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2009-06-17 |