| NPI | 1063958841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUG MITTLEIDER President Of Managing Member 470-282-3271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TN Applied For) |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2020-06-05 |