| NPI | 1073917985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMI SUE PERNELL Lpn 937-210-2725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: OH 128642) |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2014-10-21 |