| NPI | 1730124546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE MICHAEL MIXON Administrator 251-476-3420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: AL 12640) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2016-11-14 |