| NPI | 1578124582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MINA KOLTA Director Of Programs 929-305-3003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2019-06-21 |