| NPI | 1952720294 |
|---|---|
| Doing Business As | INDIGO MANOR ASSISTED LIVING |
| Entity Type | Organization |
| Authorized Contact | RANDOLPH LEE KERNON Executive Director 386-547-4686 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL5400) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-15 |