| NPI | 1033193008 |
|---|---|
| Doing Business As | THE PALMS AT PARK PLACE |
| Entity Type | Organization |
| Authorized Contact | VERN PATRICK HERZOG President 386-956-6956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: FL SNF14850951) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2012-05-08 |