| NPI | 1366433856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MCBRIDE Administrator 731-364-3158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TN 282) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2020-08-22 |