| NPI | 1922466382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZENOBIA POLK Executive Director 901-502-2135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2016-02-01 |
| Last Update Date | 2016-02-01 |