| NPI | 1851553689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA MICHELLE REYNOLDS Billing Bookkeeping 318-647-3691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2008-09-23 |