| NPI | 1619566130 |
|---|---|
| Doing Business As | GRAND COURT LAKES |
| Entity Type | Organization |
| Authorized Contact | SAMUEL POTTER President 786-220-8521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2021-01-11 |
| Last Update Date | 2021-01-20 |