| NPI | 1437178324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN TRACY THATCHER A RN P 3986-661-7032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 281P00000X Chronic Disease Hospital (Licence: FL 2793512) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-08-22 |