| NPI | 1275970204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATAKELTE ADMASU Owner/Administrator 904-766-7651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL5745) |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2013-05-31 |