| NPI | 1871217596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA NELSON Owner 701-500-2966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 177F00000X Lodging |
| 251E00000X Home Health | |
| 251G00000X Hospice Care, Community Based | |
| Enumeration Date | 2022-09-27 |
| Last Update Date | 2022-09-27 |