| NPI | 1508828120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY S BENCH Authorized Representative 941-758-4745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IA 130168) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2017-10-04 |