| NPI | 1932393121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNY BOB ROSS Owner 225-922-4466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care (Licence: LA 14010) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: LA 14010) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2007-11-26 |