| NPI | 1053286898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY FILLA Administrator 239-246-4138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Enumeration Date | 2025-10-10 |
| Last Update Date | 2025-10-10 |