NPI | 1881093714 |
---|---|
Entity Type | Organization |
Authorized Contact | WISLY NOEL Owner 904-554-6051 |
Organization Subpart ? | No |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906679) |
Enumeration Date | 2014-08-15 |
Last Update Date | 2014-08-15 |