| NPI | 1710721543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YUKETHA VONYONN POLK Owner 210-592-3710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2024-06-25 |
| Last Update Date | 2024-06-25 |