| NPI | 1376296301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY E PROVENCHER President, CEO 239-839-4997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0630X Assisted Living Facility Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2022-01-31 |