| NPI | 1104086719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT W LOCKWOOD Owner 631-669-3323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NY 700-F-131) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2008-06-17 |