| NPI | 1912322801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLADYS KANODEREKA Secretary 813-638-5803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2014-02-28 |
| Last Update Date | 2014-02-28 |