| NPI | 1114137296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA WILSON Administrator 765-932-2974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IN 4818) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |