| NPI | 1720683105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHA MANTHIA WALTERS Adminstrator/Owner 954-482-3360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2020-12-02 |