| NPI | 1760857197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERON CARMELETA FRATER Owner 321-345-5688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2022-04-10 |