| NPI | 1902279060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | P GIBONEY VP 901-562-3055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| Additional Taxonomies | 347E00000X Transportation Broker |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2015-11-10 |