| NPI | 1477846129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMLAWATY LAKRAM Administrator 772-519-4327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: FL AL9025) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2011-05-26 |