| NPI | 1376751503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD ANDRES MOGOLLON Owner 305-305-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL 9272) |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2023-04-10 |