| NPI | 1356008775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA MARIE KLEINERT Owner/Operator 779-701-7764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Additional Taxonomies | 174200000X Meals |
| 177F00000X Lodging | |
| 251E00000X Home Health | |
| 251J00000X Nursing Care | |
| 251K00000X Public Health or Welfare | |
| 251S00000X Community/Behavioral Health | |
| 253Z00000X In Home Supportive Care | |
| 310400000X Assisted Living Facility | |
| 332U00000X Home Delivered Meals | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2021-11-19 |
| Last Update Date | 2021-11-19 |