| NPI | 1063952364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANEIKA GOODWIN Stna 513-293-9696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Additional Taxonomies | 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |