| NPI | 1629181391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE WHITE Owner 863-859-7804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6905749) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-08-22 |