| NPI | 1093052359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA BERNITA JONES Program Manager 888-719-5445 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: GA LPN059388) |
| Additional Taxonomies | 374K00000X (Licence: GA LPN059388) |
| 374U00000X Home Health Aide (Licence: GA LPN059388) | |
| 376J00000X Homemaker (Licence: GA LPN059388) | |
| 376K00000X Nurse's Aide (Licence: GA LPN059388) | |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2013-01-07 |