NPI | 1508241365 |
---|---|
Entity Type | Organization |
Authorized Contact | LOVETTA LONG Owner 334-507-2368 |
Organization Subpart ? | No |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: AL 607096) |
Enumeration Date | 2015-07-22 |
Last Update Date | 2015-07-22 |