| NPI | 1972924231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANNE SMICK DEMBROWSKI Authorized Representative 772-492-5002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL9815) |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2021-10-06 |