| NPI | 1629466701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON LAMAR FERGUSON Owner Operator 323-809-0591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2014-12-24 |
| Last Update Date | 2014-12-24 |