| NPI | 1780338954 |
|---|---|
| Other Name | ADULT FAMILY CARE HOME |
| Entity Type | Organization |
| Authorized Contact | AGELET ST HUBERT Owner 904-554-6051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2022-02-07 |
| Last Update Date | 2022-02-07 |