| NPI | 1144537986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOLLIE L WALLACE Administrator/Owner 208-888-0090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: ID RC-988) |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2010-08-31 |