| NPI | 1578780920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH ROMANO Credentialing Supervisor 800-879-4471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IN 06002489A) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2007-08-30 |