| NPI | 1295136190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL PARKS Administator 727-564-4956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness (Licence: FL AL10728) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2014-09-10 |