| NPI | 1578142717 |
|---|---|
| Doing Business As | ASSISTED LIVING FACILITY |
| Entity Type | Organization |
| Authorized Contact | JONQUIL CROWOLL Owner/Administrator 754-218-7582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2021-04-05 |