| Id No | 14696 |
| Registration | Licensed |
| Bedrooms | 5 |
| Bathrooms | 5 |
| License Date | 2021-10-04 |
| Inspection Visit Count | 1 |
| Complaint Visit | 0 |
| Created | 2 years ago |
| Bedridden Waiver | No |
| Facility Type | Board and Care |
| Facility No | 565850189 |
| Capacity | 6 |
| Area | 1400 sqft |
| Inspection Last Visit | October 21, 2022 |
| Other Visit Count | 1 |
| Views | 46 |
| Hospice Waiver | 3 |