| NPI | 1164852505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMONA HERRON President 219-939-7556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: IN 33-2340044) |
| Enumeration Date | 2013-11-21 |
| Last Update Date | 2013-11-21 |