| NPI | 1619416609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLADYS "LADONNA" BENNETT Administrator 813-812-7799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL12937) |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2017-02-23 |