| NPI | 1538603824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHONDA RENEE SWEDENBURG Owner 803-646-5174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: GA PCH008654) |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2017-02-21 |