| NPI | 1275852964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNA LYNN FIRESTONE Owner 1406-293-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MT 0041013001) |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2010-05-20 |