| NPI | 1376971119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY LEWIS Administrator 352-688-9653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL11286) |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2013-10-14 |