| NPI | 1376767335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL SHELBY Administrator 270-442-6441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: KY 100626) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |