| NPI | 1871771048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA JEAN IACONA Adm 772-460-2108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL al10026) |
| Enumeration Date | 2008-02-09 |
| Last Update Date | 2008-02-09 |