| NPI | 1508576224 |
|---|---|
| Doing Business As | SHADYSIDE SKILLED NURSING AND REHABILITATION CENTER |
| Entity Type | Organization |
| Authorized Contact | MICHAEL T BERG Asst Secretary 505-468-4742 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2022-12-05 |
| Last Update Date | 2023-01-06 |