| NPI | 1881139749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YAAKOV DORFMAN Owner (Greater Than 5 Percent) 551-206-2647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2017-01-03 |