| NPI | 1992194757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA DAWN ROGERS Administrator 509-671-1729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: WA 751079) |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2015-01-16 |