| NPI | 1225397011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C. DIEDERICK VAN DER VELDE President 502-500-7798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: IN 12-003283-1) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2012-05-14 |