| NPI | 1285630954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT J ALLEN Administrator 813-972-8775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: FL SNF13770961) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2020-08-22 |