| NPI | 1487080297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN KEVIN LARKIN Cota 641-814-2275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: IA 000953) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2013-09-25 |