| NPI | 1588968937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBY EDITH FARJE Owner 786-718-4560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL11900) |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: FL AL11900) |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances (Licence: FL AL11900) | |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2010-12-28 |