| NPI | 1295912129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRINA P KATSENKO President 352-232-1986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906179) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 6906179) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-01-22 |