| NPI | 1366864795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVY FLO MOORE Owner 941-627-5983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906285) |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2014-01-21 |