| NPI | 1922051796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA TARVER Manager 318-445-4346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: LA 464) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2008-08-20 |