| NPI | 1508058660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALENE ELAINE DAVIS Owner/Operator 816-313-2515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MO 033926) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2007-08-13 |