| NPI | 1942539820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE THOMAS Executive Director 355-646-5608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| Enumeration Date | 2009-12-23 |
| Last Update Date | 2009-12-23 |