| NPI | 1962903328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY W. FLEMING Controller 971-337-3922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC HAL-092-207) |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 311Z00000X Custodial Care Facility | |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2019-03-12 |