| NPI | 1063614113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRINA A WRIGHT Lpn 931-815-3123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TN LPN0000064777) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-08-22 |