| NPI | 1811392400 |
|---|---|
| Doing Business As | GRANNY'S GARDEN HOME ALF, LLC |
| Entity Type | Organization |
| Authorized Contact | JORGE E RE Manager/Administrator 786-250-3345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL12558) |
| Enumeration Date | 2014-10-26 |
| Last Update Date | 2014-10-26 |