| NPI | 1518101609 |
|---|---|
| Other Name | RSVC -DIXIE LODGE |
| Entity Type | Organization |
| Authorized Contact | WALKER SCOTT RICHARDSON Administrator 386-734-4830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness (Licence: FL AL1077) |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2009-04-21 |