NPI | 1285861591 |
---|---|
Doing Business As | JERALD MACK SR |
Entity Type | Organization |
Authorized Contact | JERALD MACK Owner / CEO 813-965-6914 |
Organization Subpart ? | No |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906334) |
Enumeration Date | 2009-06-12 |
Last Update Date | 2009-06-12 |