| NPI | 1508269606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TOKAR Administrator 233-350-8997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2021-08-11 |