| NPI | 1982089462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT S BENNETT Manager 813-545-0682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL 12688) |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2015-07-24 |