| NPI | 1801134648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMIKA D BUTTS Owner/Operator Director Of Nursing 267-246-3222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: PA 4151228) |
| Enumeration Date | 2013-01-29 |
| Last Update Date | 2013-01-29 |