| NPI | 1609876192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH C TUTERA Manager 181-644-4090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: LA 422) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: LA 422) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2024-04-19 |