| NPI | 1184376238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIBUNDO MARCHIE Administrator 346-529-2762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2022-01-20 |