| NPI | 1790030070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERLANDE LAZARD CEO 631-228-4072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NY 417241) |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2012-07-23 |