| NPI | 1780135640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEYSEL DIAZ Owner/Administrator 813-506-3211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL 12584) |
| Enumeration Date | 2016-10-16 |
| Last Update Date | 2016-10-16 |