| NPI | 1568147379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVIN CHANDLER LEES Owner/Administrator 702-994-6699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2023-06-19 |