| NPI | 1871753962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSH GERDES Recruiter 800-798-6035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2008-06-11 |