| NPI | 1063792950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NINA MUNGO Area Region Director 757-420-1485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: VA 2306601887) |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2011-08-23 |