| NPI | 1154305688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN EARL WARREN Administrator 850-747-9688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: FL 130470978) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2020-08-22 |