| NPI | 1972044501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFONSO JAMES Lpn 646-702-4021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NY 305919) |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2017-03-15 |