| NPI | 1710636444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA T MCGILL Chief Executive Office 267-608-2233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2022-03-21 |
| Last Update Date | 2022-12-29 |