| NPI | 1932544285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKY MAYES Provider 407-416-2057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906445) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2013-04-30 |