| NPI | 1902866346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY STERLIN BALLOU Administrator 940-686-5507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TX 114470) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2022-07-21 |