| NPI | 1457040966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN HAWKINS Owner / President 954-461-7524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 251S00000X |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| Enumeration Date | 2023-05-02 |
| Last Update Date | 2023-05-02 |