NPI | 1689844912 |
---|---|
Entity Type | Organization |
Authorized Contact | KRISTA MISSEY Executive Director 618-310-1549 |
Organization Subpart ? | No |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
Enumeration Date | 2008-03-03 |
Last Update Date | 2015-12-22 |