NPI | 1316092265 |
---|---|
Doing Business As | HOME AWAY FROM HOME |
Entity Type | Organization |
Authorized Contact | TRACI A QUINN Exec.Director 219-531-6799 |
Organization Subpart ? | No |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: IN 200828810) |
Enumeration Date | 2007-01-23 |
Last Update Date | 2020-08-22 |