| NPI | 1225101819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN D PETERSON President 817-919-7495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TX 800512632) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |