| NPI | 1174803324 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | EARL A. LOGAN Director 334-220-2716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: AL Veteran Facility) |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2011-08-19 |