| NPI | 1073910816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNE FONTAINE-CARTER Member 516-754-2556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2014-11-21 |