| NPI | 1902256191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEANN CRAIG Owner 225-252-7633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: MS 1902256191) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2017-01-03 |