| NPI | 1619318318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA DAVIS Owner 727-443-0368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6905967) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2013-07-10 |