| NPI | 1619756640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY PEGGS Provider Enrollment Manager 315-261-5044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 275N00000X Medicare Defined Swing Bed Unit |
| Enumeration Date | 2023-09-28 |
| Last Update Date | 2023-09-28 |