| NPI | 1609012277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS CHARLES FOWLER Owner 208-743-2685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: ID RC-957) |
| Enumeration Date | 2009-01-01 |
| Last Update Date | 2009-01-01 |