| NPI | 1396118006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA M WIDNER Controller 225-719-2517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: LA 915) |
| Enumeration Date | 2015-11-03 |
| Last Update Date | 2015-11-03 |