NPI | 1821043621 |
---|---|
Doing Business As | DEER LODGE |
Entity Type | Organization |
Authorized Contact | MICHAEL T. BERG Assistant Secretary 505-468-4752 |
Organization Subpart ? | Yes |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MT 12681) |
Enumeration Date | 2006-05-23 |
Last Update Date | 2016-05-17 |