| NPI | 1891946372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL T BERG VP Assistant Secretary 055-468-4742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: VT N/A) |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2019-04-03 |