| NPI | 1538301478 |
|---|---|
| Other Name | PORT SOUTH VILLAGE- CRYSTAL |
| Entity Type | Organization |
| Authorized Contact | RHONDA LOCKAMY Business Office Manager 910-890-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2009-03-24 |