| NPI | 1194127357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELSIE FAY DANIELS Healthcare Provider 936-635-8691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2019-11-06 |