| NPI | 1902280506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE MILLER Owner 318-773-8643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: LA 10616713#3CF52) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2015-09-10 |