| NPI | 1679280325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSALLEN MERCADO AZUCENA Managing Member 702-683-9883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2022-11-02 |
| Last Update Date | 2022-11-02 |