| NPI | 1063750818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURI DEE FULKERTH Manager 712-335-3020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: IA S0226) |
| Enumeration Date | 2013-01-29 |
| Last Update Date | 2013-01-29 |