| NPI | 1205175908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM CHARLES MCCALLISTER Lpn 769-572-5002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MS p326102) |
| Enumeration Date | 2013-01-31 |
| Last Update Date | 2013-01-31 |