| NPI | 1528400769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY LENNARD BRADFORD Administrator 904-237-0206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL12318) |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2013-07-29 |