| NPI | 1003036955 |
|---|---|
| Former Legal Business Name | 95231514 |
| Entity Type | Organization |
| Authorized Contact | JOHN T. ALLEN Physical Therapist Assistant 888-873-4221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: CA AT4251) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |