| NPI | 1811694730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVINDRA PERSAUD Mgr 772-607-3858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 311Z00000X Custodial Care Facility | |
| Enumeration Date | 2023-02-10 |
| Last Update Date | 2024-04-09 |