| NPI | 1659595551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW BASS Owner 870-733-1235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: AR 120) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2008-06-10 |