| NPI | 1649343195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA K WAGNER CFO 870-886-1263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: AR 196) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: AR 196) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2018-12-11 |