| NPI | 1497115265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA CELES JOHNSON Owner 813-251-8506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906609) |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2016-03-07 |