| NPI | 1518176825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVERARDO CHAVIANO Administrator 3005-681-3739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL AL10608) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |