| NPI | 1952159865 |
|---|---|
| Doing Business As | MIRA VIE AT FANWOOD |
| Entity Type | Organization |
| Authorized Contact | BILLIE ABREU Director Of Admin 813-330-2660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2024-05-07 |
| Last Update Date | 2024-08-16 |