NPI | 1306101035 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID T. HENRY Delegated Official 318-629-1588 |
Organization Subpart ? | No |
Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: LA l010682) |
Enumeration Date | 2012-07-09 |
Last Update Date | 2012-07-09 |