| NPI | 1023315769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINGER GORDON BUCKLEY PT A 731-217-3227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TN 4834) |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2011-02-15 |