| NPI | 1538034715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA L WADE Owner 731-394-2886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2025-10-08 |
| Last Update Date | 2025-10-08 |