| NPI | 1518541051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE WILGER President 904-386-6636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2021-05-12 |