| NPI | 1912301383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN M TRAYLOR Manager 334-749-1471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: AL N5401) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2022-02-02 |