| NPI | 1669190989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERAMY B WILLIAMS Co Owner / Administrator 225-220-2271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2022-08-22 |