NPI | 1235676156 |
---|---|
Doing Business As | RENAISSANCE TERRACE |
Entity Type | Organization |
Authorized Contact | DOUGLAS M WRIGHT Managing Member 662-680-3148 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TN 212) |
Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TN 212) |
Enumeration Date | 2017-01-30 |
Last Update Date | 2017-05-26 |