| NPI | 1902397854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM LEROY WILCOX Administrator 239-691-0686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL 13175) |
| Enumeration Date | 2018-05-27 |
| Last Update Date | 2018-05-27 |