| NPI | 1255328399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY KEITH CARPENTER Administrator 904-724-5933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: FL SNF1508095) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2020-08-22 |