| NPI | 1154174530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEYONIE JAMES Owner/Licensee Designee 702-628-6809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2024-04-08 |
| Last Update Date | 2024-04-08 |