| NPI | 1093463309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA ROBERSON Co Owner 346-516-6503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2022-03-15 |