| NPI | 1003531526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARDA NICOLE JOHNSON CEO 662-402-6452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2022-10-06 |
| Last Update Date | 2022-10-06 |