| NPI | 1083992200 |
|---|---|
| Doing Business As | SOUTHERLAND PLACE |
| Entity Type | Organization |
| Authorized Contact | DORENE M FORD Director Of MIS 239-963-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: TN ACL0000000300) |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2011-07-22 |