| NPI | 1275703779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORA JULA Provider 360-576-3530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: WA 489102) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2008-03-11 |