| NPI | 1316913205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY B WEAVER President 641-562-2844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IA 950348) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IA 950348) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2013-11-12 |