| NPI | 1447644653 |
|---|---|
| Doing Business As | MARIE SANDRA JEANNOT |
| Entity Type | Organization |
| Authorized Contact | MARIE SANDRA JEANNOT Administrator 813-506-3907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906746) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2015-03-25 |