NPI | 1225639271 |
---|---|
Doing Business As | 3323 GAIL LANE |
Entity Type | Organization |
Authorized Contact | ANNA TODD Operations Business Manager 800-299-5161 |
Organization Subpart ? | Yes |
Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
Enumeration Date | 2020-11-05 |
Last Update Date | 2020-11-05 |