| NPI | 1457781965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER T DEROSA Administrator 813-300-6177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL-12249) |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2013-11-19 |