| NPI | 1841797354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAKAELA OBI Owner 904-728-7474 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: FL 6906906) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-04-11 |