| NPI | 1104515949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN SCHOTT Licensee / Administrator 626-861-1124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-05-08 |