| NPI | 1750412672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CATHERINE PROFFITT Owner 641-856-8344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: IA R542) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |