| NPI | 1649674839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL D FARMER Owner 209-418-7328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 311Z00000X Custodial Care Facility | |
| Enumeration Date | 2014-10-16 |
| Last Update Date | 2014-10-22 |