| NPI | 1962690297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM DAVID FLETCHER President 904-387-4481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: FL 60080967) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2016-09-29 |