| NPI | 1982723466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM LEM HEAN Owner 970-210-0292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2016-01-22 |