| NPI | 1598160186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER LEE JACOBS Owner 360-518-9998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: WA 201140065RN) |
| Enumeration Date | 2014-10-26 |
| Last Update Date | 2014-10-26 |