| NPI | 1710381710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH JEAN WAGNER Msn, RN, Anp Bc, Gnp Bc, Cnor 334-714-6931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: AL 1 039213) |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2014-10-20 |