| NPI | 1063925303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY DUKE DOTSON Owner/Operator 620-387-0005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: KS B011004) |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2017-11-08 |