| NPI | 1558879601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALIN BUZAS Provider 360-433-5496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: 751006) |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2018-06-16 |