| NPI | 1053316331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAURA PANOS Accountant 817-444-2516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TX 113069) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2020-08-03 |