| NPI | 1811218324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M. CAWOOD-GRAY Risk Consultant 423-975-5455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TN 0000000221) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TN 0000000221) |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2012-02-13 |