| NPI | 1023132685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY MAXEY Business Owner 505-489-3034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NM 91080509) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2008-06-13 |