| NPI | 1053583617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN O. REESE President 509-457-6954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: WA 601683010) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2008-04-14 |