| NPI | 1508187402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA LYNN MARTIN Lpn 315-559-8948 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: NY 248666) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2010-06-15 |