| NPI | 1538330832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MAY POTRA Provider 253-850-8439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: WA 695200) |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2008-03-14 |