| NPI | 1790027241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER TOPIC Owner 239-656-0019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6905782) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2013-03-22 |