| NPI | 1053324335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVIN EHRLICH SVP 678-443-6772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WY 05-174-Poplar) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: WY 05-183-Sheridan) |
| 314000000X Skilled Nursing Facility (Licence: WY 05-192-Cheyenne) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2022-07-21 |