| NPI | 1952725483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBERT DOMINGUEZ Owner 813-956-2663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL11199) |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2014-02-05 |