| NPI | 1487091302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA D LEWIS Owner 817-504-2702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2013-06-01 |
| Last Update Date | 2013-06-01 |