| NPI | 1093167926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE A TAYLOR Lpn 571-275-9598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility Nursing Care, Pediatric (Licence: OH LPN 161473) |
| Enumeration Date | 2016-07-03 |
| Last Update Date | 2016-07-03 |