| NPI | 1396964011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY OCHS Program Manager 863-607-5948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: FL PTA14040) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |