| NPI | 1134058597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED SAID Owner/Director 920-515-1789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2026-05-13 |
| Last Update Date | 2026-05-13 |