| NPI | 1922371863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTANA SMITH Member/Manager 318-237-6822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2012-02-22 |
| Last Update Date | 2012-02-22 |