| NPI | 1497191308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANIECE THERMIDOR Provider 239-209-7894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906547) |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2013-05-17 |