| NPI | 1649748518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW KISSOON Administrator 772-201-7655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2018-11-08 |