| NPI | 1912922147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP PEPITON Administrator 318-922-3404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: LA 240) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2011-03-16 |