| NPI | 1336504042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MASSIEL REYNALDO PAJAN Administrator 813-775-8689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: FL AL12485) |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2015-12-22 |