| NPI | 1295967891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFREDO EHICHOYA EGBADON Owner 913-909-7298 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2009-08-14 |
| Last Update Date | 2009-08-14 |