| NPI | 1316064017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY MISTY DAWN HMIELEWSKI Occupational Therapy Assistant 800-879-4471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IN 32000636A) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |