| NPI | 1982845467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANCI S SHAW Director 337-948-3194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: LA 1016021) |
| Enumeration Date | 2009-03-13 |
| Last Update Date | 2009-03-13 |