| NPI | 1669836722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETHIA LASHAY BANNER Lpn 567-249-7660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: OH 138871) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-04-05 |