| NPI | 1316448723 |
|---|---|
| Other Name | NON AT THIS TIME |
| Entity Type | Organization |
| Authorized Contact | TAN VATANADILOK Owner 210-379-7340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-02-22 |