| NPI | 1881094860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH OLUKANNI Assistant Program Director 757-450-9827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |