| NPI | 1912685900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KANEATRA GARNER Owner 321-279-0011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 310400000X Assisted Living Facility | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2023-07-10 |