| NPI | 1790152866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SABRINA MALLORY Cna/Owner 904-333-0164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL CNA232585) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2015-08-25 |