| NPI | 1386648962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEKE GAVIN CATEAU Administrator 404-688-6731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 376G00000X Nursing Home Administrator |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: GA 1060142) |
| 163WA2000X Registered Nurse, Administrator | |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2016-10-06 |