| NPI | 1124219894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAGWANDAI SINGH Provider 239-574-6493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906099) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |