| NPI | 1437594207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALORIE WALLACE Administrator 904-631-1956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL 9260) |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2013-05-07 |