| NPI | 1386845287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY EARLEAN MARVIN Home Health Aid 208-550-2638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: ID ID OOO16921203) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2020-08-22 |