| NPI | 1316130008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BIRDIA LEE FORD Adi MIS Trator/Manager/Owner 817-375-0358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2007-08-25 |
| Last Update Date | 2007-08-25 |