| NPI | 1376987339 |
|---|---|
| Former Legal Business Name | NONE |
| Entity Type | Organization |
| Authorized Contact | JORGE DOMINGUEZ Manager 305-849-5777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2013-04-22 |