| NPI | 1972744209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLENE SPENCER Owner/Caretaker 904-766-0307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6905980) |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2009-03-19 |