NPI | 1700078110 |
---|---|
Entity Type | Organization |
Authorized Contact | AMY JO VAN KLEECK Administrator 863-471-2766 |
Organization Subpart ? | No |
Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL10086) |
Enumeration Date | 2007-08-10 |
Last Update Date | 2007-08-10 |