| NPI | 1891049102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARHAN SIDDIQUI CEO 478-972-0277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282E00000X |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2012-11-26 |