| NPI | 1053184689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEORELLA A BAUTISTA Managing Member 702-985-6847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2023-11-06 |