| NPI | 1457773780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS DEAN Administrator 386-447-7405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL 12111) |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2014-01-06 |