| NPI | 1760639199 |
|---|---|
| Doing Business As | MOUNTAIN TRACE NURSING CENTER |
| Entity Type | Organization |
| Authorized Contact | ABRAHAM N/A SHAULSON President 305-864-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2008-08-27 |