| NPI | 1003198565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY JONES Program Administrator 239-461-8375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility Nursing Care, Pediatric |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2011-09-12 |