| NPI | 1225524259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA R CASON-NOBLE A RN P 772-708-8077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: FL 9272218) |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2018-07-02 |