| NPI | 1023519766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERIAN PETCHER Regional Director Of Operations 980-275-0974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: 1204) |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2018-02-27 |