| NPI | 1487880878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY L. WILLITZER Owner 813-220-6241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: FL L09000050499) |
| Enumeration Date | 2009-05-31 |
| Last Update Date | 2009-05-31 |