| NPI | 1568746998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENYA PHILIPS Owner 469-265-6701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 251J00000X Nursing Care | |
| 310400000X Assisted Living Facility | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 313M00000X Nursing Facility/Intermediate Care Facility | |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2012-10-20 |