| NPI | 1477576346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON SILLS Administrator 731-663-2335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TN 0000000030) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: TN 0000000030) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-06-23 |