| NPI | 1790540433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVRONIE JUSTIN TERMILIEN Authorized Official 321-460-8125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2024-02-20 |
| Last Update Date | 2025-10-21 |