| NPI | 1255322087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY DEAN CHINN Member 360-794-9020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: ID 003266800) |
| Enumeration Date | 2005-11-01 |
| Last Update Date | 2012-04-05 |