| NPI | 1265278915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSTREIN V GOODE Management 210-416-4585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2024-07-02 |
| Last Update Date | 2024-07-02 |