| NPI | 1891939492 |
|---|---|
| Other Name | 23 PLEASANT ST |
| Entity Type | Organization |
| Authorized Contact | LISA BOLEN Accounting Manager 2077-822-7262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-04-27 |