| NPI | 1639652944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUG MITTLEIDER President Of Managing Member 470-282-3271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2018-09-12 |