| NPI | 1295166494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMORA LETITIA BLUE Stna 216-200-2494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: OH 401594961213) |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2013-12-13 |