| NPI | 1942613351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAILEEN GONZALES Administrator 813-325-6906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL 006683) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |