NPI | 1396811550 |
---|---|
Doing Business As | MODERN CARE CONVALESCENT AND NURSING HOME |
Entity Type | Organization |
Authorized Contact | GARY L POTTS Manager 423-870-3153 |
Organization Subpart ? | No |
Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IL 1764855) |
Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: IL 0047852) |
Enumeration Date | 2006-11-28 |
Last Update Date | 2007-07-19 |