| NPI | 1831574052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL T BERG Assistant Secretary 505-468-4742 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: VT 00000) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2016-08-11 |