| NPI | 1750712956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHIA FOWLKES Stna 216-213-8084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: OH 400360060504) |
| Additional Taxonomies | 311500000X Alzheimer Center (Dementia Center) (Licence: OH 400360060504) |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2013-12-12 |