| NPI | 1871025452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN LANE Administrator 727-643-8050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906897) |
| Enumeration Date | 2017-04-01 |
| Last Update Date | 2017-04-01 |