| NPI | 1881010072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA R DESMARTIN Administrator 386-466-0005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL 9402) |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2014-03-12 |