| NPI | 1073236022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENNIE RUKARWA Member 317-238-0595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 177F00000X Lodging |
| 251E00000X Home Health | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2022-09-23 |
| Last Update Date | 2022-09-23 |