| NPI | 1740986496 |
|---|---|
| Former Legal Business Name | LIVING WELL COMMUNITY HOME |
| Entity Type | Organization |
| Authorized Contact | SAMSON USHA ARGO Provider 605-370-0974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2023-02-03 |
| Last Update Date | 2023-02-03 |