| NPI | 1609205855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRI ANNE MARTIAN RN 509-426-2622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: WA RN00116189) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2013-11-08 |