| NPI | 1134597685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAHJA M EASON Lpn 585-734-5436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NY 313387) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2015-09-14 |