| NPI | 1669714168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI RANDALL Administrator 254-666-2164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TX 137613) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2014-02-10 |