| NPI | 1528679461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAKWE BONGO MCDONALD Owner 214-444-7406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-13 |