| NPI | 1275979908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS MARIO ANGLES Owner 941-378-4317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6905482) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2013-05-21 |