| NPI | 1902229321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAHVUN ROULHAC Physical Therapy Assistant 321-202-8449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2014-01-22 |