| NPI | 1316303167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INDIA LOTT Owner 901-425-6805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2016-01-10 |
| Last Update Date | 2016-01-10 |