| NPI | 1033579248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH LASKOWSKI Social Worker 8134-944-4210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL SW4663) |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2016-03-01 |