| NPI | 1578969689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETHEL P. WASHINGTON Owner 904-355-2031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6905691) |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2014-11-17 |