| NPI | 1790867497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTI WALLACE Chairman Of The Board 334-273-9002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: AL 12649) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2012-01-11 |