| NPI | 1992947170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA JONES Administrator/Cna/Bs 321-676-1714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: FL 6906308) |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2014-01-30 |