| NPI | 1629414479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AGELET ST HUBERT Owner/President 904-554-6051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: FL 6906603) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2013-05-21 |