| NPI | 1457362469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO N. PARK CEO 731-925-1181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TN 0000000121) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2020-08-22 |