| NPI | 1669762613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN DENISE FRAZIER Administrator 904-768-6741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL11707) |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2011-04-12 |