| NPI | 1457751836 |
|---|---|
| Doing Business As | A LOVING ADULT FAMILY CARE HOME |
| Entity Type | Organization |
| Authorized Contact | CRYSTAL DENISE MCFADDEN Provider 904-866-9216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906582) |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2014-09-04 |