| NPI | 1407686926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TUNJI STEPHEN ADEYEMI Administrator 346-529-5342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2024-08-07 |
| Last Update Date | 2024-09-21 |