| NPI | 1760838957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD JEROME PORTER Administrator 352-258-4015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: FL A12804) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: FL A12804) |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2016-05-06 |