| NPI | 1861354771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAXINE RICHARDO WILSON Assisted Living Manager 929-385-2731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider |
| Enumeration Date | 2025-11-29 |
| Last Update Date | 2025-11-29 |