| NPI | 1508476722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE POWERS Manager 253-999-7146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Additional Taxonomies | 3747P1801X Technician Personal Care Attendant |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2020-08-03 |