| NPI | 1962603241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JANE BLACKBURN Adminstrator Owner 941-753-5264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: FL HHA299991458) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: FL AL9427) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |