| NPI | 1356726616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNMARIE LEWIS COLEMAN Administrator 772-240-9850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL12683) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: FL AL12683) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2018-05-08 |