| NPI | 1083970982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY BROOKE FORESTER Cota/L 325-340-3393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: CA 2199) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2012-04-04 |