| NPI | 1821387481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY JEANNETTE SPAULDING Stna 6144-753-9027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: OH 321744310101) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2011-04-05 |