| NPI | 1407673312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVERNA JANENE SMITH Administrator 813-410-6636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2024-09-23 |
| Last Update Date | 2024-09-23 |