| NPI | 1093720880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID RODMAN Asst. Secretary 407-975-3011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: KY 100070) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 90003997) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2015-12-30 |