| NPI | 1457318461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDOLPH L KERNON Executive Director 386-257-4400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: FL SNF1248096) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: FL AL5400) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2014-04-07 |