| NPI | 1427139567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY TIPPIN Owner 479-489-5237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: AR 0339347500) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2008-06-17 |