| NPI | 1902115959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE MEDINA Ownder/Administrator 352-854-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL5055) |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2010-09-24 |