| NPI | 1831906247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEINDRICK AFRANDIS ADOUNVO Onwer 970-405-5916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| Enumeration Date | 2024-12-18 |
| Last Update Date | 2024-12-18 |