| NPI | 1376782177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN MARCUS TRAYLOR Administrator 334-749-1471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: AL N4103) |
| Enumeration Date | 2009-02-18 |
| Last Update Date | 2024-03-28 |