| NPI | 1376884437 |
|---|---|
| Doing Business As | MONICA L. VICKERS |
| Entity Type | Organization |
| Authorized Contact | MONICA L VICKERS President 863-206-6439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906570) |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2013-03-13 |