| NPI | 1972220184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEATRICE O OKAGBARE Owner 347-304-4051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2022-10-27 |
| Last Update Date | 2022-10-27 |