| NPI | 1609271519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIBY R JACINTO Owner/Administration 813-541-0093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL12568) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2014-11-04 |