| NPI | 1720470123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILY E STAFFORD Owner/Administrator 505-917-3553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NM 2201) |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2015-02-23 |