| NPI | 1003960824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY A. PATTON Speech And Language Pathologist 229-506-0777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: SC 4084) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-08-22 |