| NPI | 1497134456 |
|---|---|
| Doing Business As | DIVERSICARE OF CANON CITY |
| Entity Type | Organization |
| Authorized Contact | KELLY J GILL President & CEO 615-771-7575 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2015-05-23 |
| Last Update Date | 2015-05-23 |