| NPI | 1518359561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEYA T WILLIAMS Lpn 315-200-2468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NY 314670-1) |
| Enumeration Date | 2015-02-28 |
| Last Update Date | 2015-02-28 |