| NPI | 1730464637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKLENE G. HERNANDEZ CEO 754-246-9475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL12031) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2011-10-12 |