| NPI | 1255218491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANELLE JILUS Cheif Executive Officer 888-944-6264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2025-08-19 |
| Last Update Date | 2025-08-19 |