| NPI | 1720603350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELIKS POLYAKOV Director Of Patient Care 360-281-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2020-06-09 |