| NPI | 1861203663 |
|---|---|
| Doing Business As | GLADE AVENUE ASSISTED LIVING |
| Entity Type | Organization |
| Authorized Contact | LEVI SIMPSON Managing Member 347-225-1921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2025-01-20 |
| Last Update Date | 2025-01-20 |