| NPI | 1558672667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORENZO BROOKS CLEMONS President 757-301-1797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: VA HCO10624) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2010-06-24 |