| NPI | 1417232307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM LUCKY Collaborating Physician 813-952-8296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: LA RN106698-AP06667) |
| Additional Taxonomies | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances (Licence: LA RN106698-AP06667) |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2011-10-11 |