| NPI | 1033805759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAILETHA WOODS President 888-440-0915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2023-04-14 |
| Last Update Date | 2023-04-14 |