| NPI | 1124015292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENE COOK Controller 256-582-3112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: AL 475690 0S) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2020-08-22 |