| NPI | 1457231102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA BOGLE Business Manager 478-733-0504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2025-09-04 |
| Last Update Date | 2025-09-04 |