| NPI | 1902243207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA GONGORA Owner/President 786-502-7397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2013-05-28 |