| NPI | 1548529225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIBY JACINTO Owner 813-541-0093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL12114) |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2021-02-21 |