| NPI | 1649578832 |
|---|---|
| Former Legal Business Name | DALE MEDINA D/B/A HIDDEN PINES ASSISTED LIVING FACILITY |
| Entity Type | Organization |
| Authorized Contact | DALE ELAINE MEDINA Administrator 352-854-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL5505) |
| Enumeration Date | 2011-03-11 |
| Last Update Date | 2011-03-11 |