| NPI | 1154891224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUZVIMINDA IMPERIAL MONAGHAN Owner/Provider 253-301-0099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2018-11-30 |