| NPI | 1528720539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ERINGO RN 253-777-1953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 164W00000X Licensed Practical Nurse | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| Enumeration Date | 2021-10-06 |
| Last Update Date | 2021-10-06 |