NPI | 1457800708 |
---|---|
Entity Type | Organization |
Authorized Contact | CAROLYN FAYE BENTLEY Provider/Owner 904-613-2234 |
Organization Subpart ? | No |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
Enumeration Date | 2016-09-28 |
Last Update Date | 2016-09-28 |