| NPI | 1639670433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERLLANNE OCCEUS Owner 239-738-8688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: GA PCH003426) |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2019-03-14 |