| NPI | 1902157563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENESHIA WYATT President 813-900-7479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 251E00000X Home Health | |
| 251J00000X Nursing Care | |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2012-09-24 |