| NPI | 1528404928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERONA GREY Provider 941-235-3216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906531) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2013-05-13 |