| NPI | 1942298849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE MICHELLE O'DONNELL Administrator 904-772-1220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: FL SNF1007096) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2010-02-09 |