| NPI | 1003674854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN JAMIESON Np 857-225-1868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-03-07 |
| Last Update Date | 2024-11-18 |