| NPI | 1649046558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY WATSON Owner 469-437-1956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| Enumeration Date | 2023-12-01 |
| Last Update Date | 2024-01-06 |