| NPI | 1588968481 |
|---|---|
| Doing Business As | EASTLAKE TERRACE |
| Entity Type | Organization |
| Authorized Contact | JOHN MOORE CEO 502-779-7608 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2011-01-06 |