| NPI | 1285075986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS JUAN MAZARIEGOS Administrator 727-823-1625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: FL 11357) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2013-07-10 |