| NPI | 1760789424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA-LINDA PUCKETT Cota/L 931-209-3952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TN 1766) |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2011-02-16 |