| NPI | 1801212097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSALYN YVETTE GREEN Owner/Administrator 813-689-1922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL12447) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2016-02-22 |