| NPI | 1114920469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA PICKENS Administrator 731-632-3301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TN 0000000167) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2007-07-25 |