| NPI | 1588652051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE RENE WHITE Adon/ Medicare Manager 940-704-6682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2020-08-22 |