| NPI | 1841677523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMELA S OWENS President 386-527-3781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL al12638) |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2015-04-30 |