| NPI | 1467812941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FLOYD AUSTIN BRADLEY Administrator 315-782-2238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NY 330F036) |
| Additional Taxonomies | 376G00000X Nursing Home Administrator (Licence: NY 05684) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2016-02-26 |