| NPI | 1043909310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALENE NICHOLE PORCH Owner 216-926-9243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2023-05-03 |