| NPI | 1518464478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY KERONCHE OMBICHA Executive Director 551-358-1308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2018-04-08 |
| Last Update Date | 2018-04-10 |