| NPI | 1154765808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLIE GLEE NDIAYE CEO 662-289-7676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 347C00000X Private Vehicle |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: MS 45383910) |
| 385H00000X Respite Care | |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2022-07-21 |