| NPI | 1578726964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM D SWARTOUT Owner/Operator 904-291-1962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6905291) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2008-07-07 |