| NPI | 1285414813 |
|---|---|
| Doing Business As | AWAY FROM HOME ADULT CARE |
| Entity Type | Organization |
| Authorized Contact | BRIEN SONSON Managing Member 702-415-3284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2023-10-02 |
| Last Update Date | 2023-10-02 |