| NPI | 1891193413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES EDWARDS Member 765-714-5439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: SC CRC-0743) |
| Enumeration Date | 2014-12-13 |
| Last Update Date | 2014-12-13 |