| NPI | 1104507789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAMEKA L DAVIS Managing Member 702-518-4331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based |
| 311Z00000X Custodial Care Facility | |
| Enumeration Date | 2023-07-27 |
| Last Update Date | 2023-07-27 |