| NPI | 1306249149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARA LEE FERGUSON Administrator/Owner 386-487-5029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL12314) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2014-10-13 |