| NPI | 1477160778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE DIANE ROBERTSON Owner 433-422-0249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2020-09-30 |