| NPI | 1164749065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELVIRA JOANNA THOMAS Lpn 516-538-7229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NY 190158-1) |
| Enumeration Date | 2010-05-01 |
| Last Update Date | 2010-05-01 |