| NPI | 1811042005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN BEROY DASCO Administrator 386-503-3133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL10729) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |