| NPI | 1922535137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETITIA SHANTEL KNOWLES Owner/Administrator 772-940-6771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2017-05-22 |