| NPI | 1134495500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH OWENS Residential Manager 901-451-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2012-03-29 |