| NPI | 1831804657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATSARA CHANTHARASETH Licensee 657-722-9269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2023-01-16 |
| Last Update Date | 2025-07-11 |