| NPI | 1780099861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M. CAWOOD-GRAY Risk Consultant 423-773-4485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2015-01-28 |