| NPI | 1467821512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLETTE KATRELL HOLMES Administrator 904-673-7212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL12677) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2015-09-18 |