| NPI | 1649462359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA RENEE ANDERSON RN 386-916-6755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: FL RN2047752) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2007-08-16 |