| NPI | 1902404668 |
|---|---|
| Former Legal Business Name | TAMBOLINA SERVICES COMMUNITY RESIDENT HOME |
| Entity Type | Organization |
| Authorized Contact | TAMBA MEDZA MOMORIE Associate Administrator 904-629-9922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-10-15 |