| NPI | 1144491713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BIRDIE MAE KING Administrator 323-293-8444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2008-03-21 |