| NPI | 1215715941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: CA 6038424740) |
| Additional Taxonomies | 311500000X Alzheimer Center (Dementia Center) (Licence: CA 6038424740) |
| Enumeration Date | 2023-09-14 |
| Last Update Date | 2023-09-14 |