| NPI | 1538825328 |
|---|---|
| Former Legal Business Name | WILLIAMS, MAVIS |
| Entity Type | Organization |
| Authorized Contact | MAVIS WILLIAMS Owner 954-632-3815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2022-01-04 |