| NPI | 1134591258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE THERESA HARTLEY Administrator Owner 386-334-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2015-10-28 |