| NPI | 1912446360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILIAN MOKUA Administrator 321-217-9058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL 12963) |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2017-02-17 |