| NPI | 1962777177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEATRICE WHITLEY Supervisor 1727-808-1093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: FL 19623) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2012-03-21 |