| NPI | 1770755142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT DONALD DURANTE Secretary/Treasurer 360-896-9417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: WA 208001) |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2008-03-26 |