| NPI | 1972331106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATRINA JOHNSON President 863-677-6031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-07-22 |