| NPI | 1760894810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMELA SUE OWENS Administrator 386-527-3781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL 12422) |
| Enumeration Date | 2014-05-23 |
| Last Update Date | 2014-05-23 |