| NPI | 1417175860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA J EARP Controller 863-293-0072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL 5504) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |