| NPI | 1104247717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARNULFO SALGADO SIMONDAC Administrator 386-589-6252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: FL 12025) |
| Enumeration Date | 2013-12-27 |
| Last Update Date | 2013-12-27 |