| NPI | 1235910118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JESUS CHAVEZ Owner 915-346-2475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| Enumeration Date | 2023-10-09 |
| Last Update Date | 2023-10-11 |