| NPI | 1740038488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MBAPNGONG ANU Owner 215-594-1824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| Enumeration Date | 2024-05-08 |
| Last Update Date | 2024-05-08 |