| NPI | 1710677364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA WAHU MBURU Entity Representative 574-707-5898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-05-08 |