| NPI | 1063602639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY L ELLIOTT Account Manager 314-878-0163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2007-11-27 |