| NPI | 1972266351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAMIN TRAWALLY Administrator 347-368-3855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2021-10-21 |