| NPI | 1578571808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID H. DENNIS Administrator 254-897-1448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2010-01-13 |