| NPI | 1558782722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKISHA CALHOUN Stna 216-258-5663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: OH 379692680301) |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2013-12-13 |