| NPI | 1508129776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASEY KRISTINE COTTERMAN Occupational Therapist Assistant 567-204-7962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: VA 9) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2022-07-21 |