| NPI | 1992329817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY VICTORIA Director Of Operations 774-506-2168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 347C00000X Private Vehicle | |
| 385H00000X Respite Care | |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2025-03-26 |