| NPI | 1972963643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BIEN J CONCEPCION President 224-520-0320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2016-02-24 |