| NPI | 1104398866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS JOY WRIGHT Director Decision Support 706-828-2445 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Additional Taxonomies | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2018-12-19 |