| NPI | 1679152250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERLYNE BRYANT Administrator 754-246-2349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Additional Taxonomies | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| 385H00000X Respite Care | |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2022-09-09 |