| NPI | 1669987293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAKAELA OBI Owner 904-728-7474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906906) |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2018-04-09 |