| NPI | 1154558690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA LANE Administrator 478-737-0350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: GA 1-121-1951) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2023-09-28 |