| NPI | 1447032941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWIGHT BRENDAN GIBB Owner/Provider 509-987-8937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2023-10-18 |
| Last Update Date | 2023-10-18 |