| NPI | 1336212844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL T. BERG Assistant Secretary 505-468-4752 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MO 042339) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2016-01-26 |