| NPI | 1922218031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA PREMO Administrator 812-275-7006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IN 4843) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2012-01-06 |