| NPI | 1306017124 |
|---|---|
| Doing Business As | GRACE LAND ADULT FAMILY HOME |
| Entity Type | Organization |
| Authorized Contact | FE PANGAN CAVA Owner 360-687-4433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2008-03-19 |