| NPI | 1962846469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA FAYE KEDDY Owner 772-287-8583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906554) |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2013-04-26 |