| NPI | 1649972480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYISHA ANNALISA PONDEXTER Member 559-312-3377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2023-03-17 |
| Last Update Date | 2023-03-17 |