| NPI | 1265608236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY JOSE-RODDY Executive Director 671-325-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: MA 1041) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2013-06-25 |