| NPI | 1972181998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M CAWOOD GRAY Delegated Official, Registrations O 423-557-6116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2022-01-31 |