| NPI | 1982067591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLA POLYAKOV Director Of Patient Care 360-524-5653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: WA 751903) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2016-03-31 |