| NPI | 1790786614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BOULDIN Administrator 931-823-6403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TN 0000000200) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TN 0000000200) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2015-03-12 |