| NPI | 1750618690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERLY BOURSIQUOT Social Worker 305-305-3857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: FL 15426398) |
| 311Z00000X Custodial Care Facility (Licence: FL 311z00000x) | |
| Enumeration Date | 2009-11-13 |
| Last Update Date | 2009-11-13 |