| NPI | 1962759738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CECROPIA BALLARD Executive Director 850-577-0208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: FL SW7996) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: FL SW7996) |
| 310400000X Assisted Living Facility (Licence: FL SW7996) | |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2012-08-10 |