| NPI | 1306847850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS W PENLEY Office Manager 706-855-1773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2020-08-22 |