| NPI | 1154728590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVERN WASHINGTON HUMPHRIES Registered Nurse 254-931-7140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: TX 836362) |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2014-12-01 |