| NPI | 1619353091 |
|---|---|
| Doing Business As | DBA MY HOUSE |
| Entity Type | Organization |
| Authorized Contact | JEREMY DAVID WINANS Qidp 559-905-9806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2015-08-07 |