NPI | 1124563697 |
---|---|
Entity Type | Organization |
Authorized Contact | LUCIA NGATIA Provider 774-262-3858 |
Organization Subpart ? | No |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: WA 752761) |
Enumeration Date | 2016-12-19 |
Last Update Date | 2016-12-19 |