| NPI | 1902129653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN RIDDLE Recruiting Manager 866-433-9555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MO 117346) |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2010-03-09 |