| NPI | 1073924296 |
|---|---|
| Doing Business As | FOREST LAKE MANOR |
| Entity Type | Organization |
| Authorized Contact | JAMES CHRISTOPHER LANDERS President/CEO 662-895-1801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL8869) |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2014-05-09 |