| NPI | 1790069656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN DWAYNE GRAYSON Vice President 304-417-4969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: WV 507554) |
| Enumeration Date | 2011-10-10 |
| Last Update Date | 2011-10-10 |