| NPI | 1760824528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENES I FONSECA Administrator 813-935-1710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL12334) |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2013-07-22 |