| NPI | 1285043026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSTY ALAN LUDLOW Administrator 813-210-7462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL 12421) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2014-08-06 |