| NPI | 1962788646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R. MARK CRONQUIST Manager 404-574-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: FL SNF11610951) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2014-09-29 |