| NPI | 1912310335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEKELA SHANTA SIMMONS Owner/ CEO 864-417-9291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2015-02-24 |