| NPI | 1679944466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLADYS KANODEREKA Owner 813-530-0909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL12249) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2020-03-03 |