| NPI | 1174366496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUANTAE GRAY Owner 225-288-8278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2024-06-14 |
| Last Update Date | 2024-06-14 |