| NPI | 1356747869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN BANKS Director 800-507-6404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NM 1T 2248) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2014-11-10 |