| NPI | 1649638495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYNELLE J FORDE Administrator 727-688-1918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2016-02-08 |