| NPI | 1336596063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSANNA HART President 360-629-6612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: WA 753097) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2016-05-23 |